Röhrig G, Rappl G, Vahldick B, Kaul I, Schulz R J
Klinik für Geriatrie, St. Marien-Hospital, Kunibertskloster 11-13, 50668, Köln, Deutschland,
Z Gerontol Geriatr. 2014 Jan;47(1):51-6. doi: 10.1007/s00391-013-0508-6.
Iron deficiency anemia (IDA) and anemia of chronic diseases (ACD) are common in the geriatric population. However, differentiation between IDA and ACD is still problematic. Hepcidin is a key regulator of iron homeostasis: downregulation in the presence of iron deficiency allows enteral iron resorption, while upregulation in case of chronic inflammation blocks it. We aimed at studying whether serum hepcidin levels might serve as diagnostic parameter to differentiate between IDA and ACD among elderly.
A total of 37 patients (age 69-97 years) were divided into 4 groups: group I (IDA), group II (ACD), group III (controls), and group IV (IDA/ACD). Serum hepcidin levels were analyzed using a commercially available ELISA kit (DRG Instruments, Marburg, Germany). Differences in hepcidin levels were tested with nonparametric methods.
We could show a strong positive correlation between serum hepcidin and ferritin (Spearman rho 0.747) and a statistic significant difference of hepcidin levels among all groups (p = 0.034). Hepcidin levels between ACD and controls differed significantly (p = 0.003).
Despite the small number of patients included in this study, which reduces the strength of the study's evidence, results conform with the current literature: it can be assumed that hepcidin will be used as a diagnostic parameter to differentiate between IDA and ACD in the future. However, more studies with larger patient groups are urgently needed to answer this question.
缺铁性贫血(IDA)和慢性病贫血(ACD)在老年人群中很常见。然而,IDA和ACD之间的鉴别仍然存在问题。铁调素是铁稳态的关键调节因子:缺铁时下调可使肠道铁吸收,而慢性炎症时上调则会阻断铁吸收。我们旨在研究血清铁调素水平是否可作为鉴别老年人IDA和ACD的诊断参数。
共37例患者(年龄69 - 97岁)分为4组:I组(IDA)、II组(ACD)、III组(对照组)和IV组(IDA/ACD)。使用市售ELISA试剂盒(德国马尔堡DRG仪器公司)分析血清铁调素水平。用非参数方法检验铁调素水平的差异。
我们发现血清铁调素与铁蛋白之间存在强正相关(Spearman秩相关系数为0.747),且所有组间铁调素水平存在统计学显著差异(p = 0.034)。ACD组与对照组的铁调素水平差异显著(p = 0.003)。
尽管本研究纳入的患者数量较少,降低了研究证据的强度,但结果与当前文献一致:可以假设未来铁调素将用作鉴别IDA和ACD的诊断参数。然而,迫切需要更多纳入更大患者群体的研究来回答这个问题。