Al-Hakeim Hussein K, Al-Khakani Manal M, Al-Kindi Mahmood A
Department of Chemistry, College of Science, Kufa University, Iraq.
Department of Internal Medicine, College of Medicine, Kufa University, Iraq.
Adv Clin Exp Med. 2015 Jan-Feb;24(1):69-78. doi: 10.17219/acem/38158.
Hepcidin is a master regulator of iron metabolism that inhibits the transport of iron out of enterocytes and macrophages. Thalassemia major (TM) is associated with some of the endocrine disorders. However, studies have yet to be conducted on the correlation of hepcidin with hormone levels and insulin resistance (IR) in patients with TM.
In the present study, the correlation of hepcidin level with some endocrine and biochemical parameters was investigated to determine the factors that mainly affect hepcidin correlation in patients with thalassemia. These factors include hormones, iron status, and IR parameters.
Hepcidin and other measured biochemical parameters were compared between the TM patients (100) and healthy children (37).
Serum thyroid-stimulating hormone (TSH) was positively correlated (p < 0.05) with hepcidin, iron, and ferritin. T4 hormone was correlated with ferritin only. Other hormones showed different correlation patterns with iron status parameters but were statistically insignificant (p > 0.05). The percentage of β-cell function was the only parameter among the IR parameters that showed a significant difference between thalassemic and control groups.
Thyroid and β-cells dysfunctions are common in TM patients with frequent blood transfusions. In addition, hepcidin and TSH levels can be predicted significantly using the most correlated factors with hepcidin. These factors, including ferritin, insulin and TSH were used to construct predicting equations: S. Hepcidin = 0.003Ferritin + 3.02TSH + 0.12*Insulin + 16.85 (± 7.78) and TSH = 0.0083 × Insulin + 0.0042 × Ferritin + 0.0937 × Hepcidin + 1.91 (± 1.373).
铁调素是铁代谢的主要调节因子，可抑制铁从肠上皮细胞和巨噬细胞中输出。重型地中海贫血（TM）与一些内分泌紊乱有关。然而，关于铁调素与TM患者激素水平及胰岛素抵抗（IR）之间的相关性研究尚未开展。
在本研究中，调查铁调素水平与一些内分泌及生化参数之间的相关性，以确定主要影响地中海贫血患者铁调素相关性的因素。这些因素包括激素、铁状态和IR参数。
比较100例TM患者和37例健康儿童的铁调素及其他测量的生化参数。
血清促甲状腺激素（TSH）与铁调素、铁和铁蛋白呈正相关（p < 0.05）。T4激素仅与铁蛋白相关。其他激素与铁状态参数呈现不同的相关模式，但无统计学意义（p > 0.05）。IR参数中，β细胞功能百分比是地中海贫血组与对照组之间唯一显示出显著差异的参数。
频繁输血的TM患者常见甲状腺和β细胞功能障碍。此外，使用与铁调素相关性最强的因素可显著预测铁调素和TSH水平。这些因素包括铁蛋白、胰岛素和TSH，用于构建预测方程：血清铁调素 = 0.003×铁蛋白 + 3.02×TSH + 0.12×胰岛素 + 16.85（± 7.78），TSH = 0.0083×胰岛素 + 0.0042×铁蛋白 + 0.0937×铁调素 + 1.91（± 1.373）。
