Clinical Pathology Laboratory Unit, Istituto Giannina Gaslini, Largo G. Gaslini 5, Genoa, Italy.
Eur J Haematol. 2013 Apr;90(4):323-30. doi: 10.1111/ejh.12081. Epub 2013 Feb 26.
Hepcidin, a peptide hormone released by hepatocytes into circulation is the main regulator of dietary iron absorption and cellular iron release. Although commercial tests are available, assay harmonization for hepcidin has not been yet reached, making reference intervals and consequent clinical decisions still elusive for each assay and specific population. The aim of this study is to set up hepcidin measurement in pediatric age and to investigate its potential usefulness in the diagnosis and management of iron disorders in children.
Serum hepcidin was measured by using an automated commercial immunoassay. Reference values were obtained from 86 healthy children. Hepcidin was then evaluated in 52 children with diseases where this hormone was expected to be differently regulated.
Hepcidin values were 43.6 ng/mL median; 32-52.7 1-3 q: in males and 36.4 ng/mL median; 28.5-45.7 1-3 q: in females (P = 0.039). Hepcidin was significantly higher in postpubertal normal females than in normal males. Hepcidin resulted up-regulated in anemia of chronic disease of children affected by systemic Juvenile Idiopathic Arthritis and decreased after treatment with anakinra, an anti-interleukin-1 receptor antagonist. In iron deficiency anemia patients on oral iron supplementation and in β-thalassemia subjects, hepcidin levels were similar to those found in healthy subjects.
This study sets up reference values for pediatric population and shows that in normal controls serum hepcidin react differently to puberty in females vs. males. In addition, it suggests that serum hepcidin may discriminate microcytic inflammatory anemia of Juvenile Idiopathic Arthritis from iron deficiency anemia. Overall these findings may represent a helpful tool for future studies tailored to understand the role of hepcidin in management of iron disorders in children.
肝素有肽激素由肝细胞分泌到循环中，是调节膳食铁吸收和细胞铁释放的主要调节剂。虽然有商业检测方法，但肝素有肽的检测尚未实现标准化，因此每种检测方法和特定人群的参考区间和相应的临床决策仍然难以确定。本研究旨在建立儿科年龄的肝素有肽测量方法，并研究其在儿童铁代谢紊乱的诊断和治疗中的潜在用途。
使用自动化商业免疫分析法测量血清肝素有肽。从 86 名健康儿童中获得参考值。然后评估了 52 名患有预期激素调节不同疾病的儿童的肝素有肽。
肝素有肽值中位数为 43.6ng/ml；32-52.71-3 q:男性和 36.4ng/ml中位数；28.5-45.71-3 q:女性（P=0.039）。青春期后正常女性的肝素有肽明显高于正常男性。患有全身性幼年特发性关节炎的儿童的慢性疾病性贫血时，肝素有肽上调，并用白细胞介素-1 受体拮抗剂 anakinra 治疗后降低。在口服铁补充治疗的缺铁性贫血患者和β-地中海贫血患者中，肝素有肽水平与健康受试者相似。
本研究为儿科人群建立了参考值，并表明在正常对照中，血清肝素有肽在女性和男性对青春期的反应不同。此外，它表明血清肝素有肽可区分幼年特发性关节炎的小细胞炎症性贫血与缺铁性贫血。总的来说，这些发现可能代表了一种有用的工具，可用于未来的研究，以了解肝素有肽在儿童铁代谢紊乱管理中的作用。
