Chen Szu-Ta, Ni Yen-Hsuan, Li Chuan-Chun, Liu Shing-Hwa
Department of Pediatrics, National Taiwan University Hospital Yun-Lin Branch, National Taiwan University, Taiwan; Department of Pediatrics, National Taiwan University Children's Hospital, National Taiwan University, Taiwan; Graduate Institute of Toxicology, College of Medicine, National Taiwan University, Taiwan; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Department of Pediatrics, National Taiwan University Children's Hospital, National Taiwan University, Taiwan.
Pediatr Neonatol. 2018 Dec;59(6):611-617. doi: 10.1016/j.pedneo.2018.02.007. Epub 2018 Feb 9.
Helicobacter pylori infection is associated with iron deficiency (ID) in children. Inflammatory cytokine reactions could influence the consequences of H. pylori infection. Hepcidin is an important regulator in iron homeostasis and could be induced by chronic inflammation. The relationship between hepcidin and cytokine levels in children infected with H. pylori remains controversial.
Based on serology testing for anti-H. pylori IgG, participants (43 seropositive and 43 seronegative) aged 10-18 years were enrolled. Serum hepcidin levels and iron profiles, including iron, ferritin, and total iron-binding capacity, were measured. ID is defined as iron saturation less than 15%. Seropositive children were divided into low hepcidin (n = 22) and high hepcidin (n = 21) groups. IL-1β, IL-6, and IL-8 serum levels were compared.
Serum IL-1β and IL-6 levels were comparable between H. pylori seropositive and seronegative children, as were the median serum hepcidin levels (6.5 ng/mL versus 8.6 ng/mL; P = 0.1318). Median levels of serum iron, ferritin, and iron saturation were significantly lower in seropositive children with low hepcidin than in those with high hepcidin (P = 0.0123, P = 0.0001, and P = 0.0004, respectively). The prevalence of ID was significantly higher in those with low serum hepcidin levels (33.3% versus 4.5%; P = 0.015). Compared to the high hepcidin seropositive group, the low hepcidin group had significantly lower median serum levels of cytokines IL-1β and IL-6, but not IL-8 (P = 0.0151 and P = 0.0015, respectively).
Inflammatory cytokines IL-1β and IL-6, but not IL-8, might be associated with increased hepcidin levels among H. pylori-seropositive children. Further studies are needed to clarify the role of hepcidin.
幽门螺杆菌感染与儿童缺铁（ID）有关。炎性细胞因子反应可能会影响幽门螺杆菌感染的后果。铁调素是铁稳态的重要调节因子，可由慢性炎症诱导。幽门螺杆菌感染儿童中铁调素与细胞因子水平之间的关系仍存在争议。
基于抗幽门螺杆菌IgG的血清学检测，纳入了10至18岁的参与者（43例血清阳性和43例血清阴性）。测量血清铁调素水平和铁参数，包括铁、铁蛋白和总铁结合力。ID定义为铁饱和度低于15%。血清阳性儿童分为低铁调素组（n = 22）和高铁调素组（n = 21）。比较IL-1β、IL-6和IL-8的血清水平。
幽门螺杆菌血清阳性和血清阴性儿童的血清IL-1β和IL-6水平相当，血清铁调素中位数水平也相当（6.5 ng/mL对8.6 ng/mL；P = 0.1318）。低铁调素的血清阳性儿童的血清铁、铁蛋白和铁饱和度中位数水平显著低于高铁调素的儿童（分别为P = 0.0123、P = 0.0001和P = 0.0004）。血清铁调素水平低的儿童中ID的患病率显著更高（33.3%对4.5%；P = 0.015）。与高铁调素血清阳性组相比，低铁调素组的细胞因子IL-1β和IL-6的血清中位数水平显著更低，但IL-8并非如此（分别为P = 0.0151和P = 0.0015）。
炎性细胞因子IL-1β和IL-6而非IL-8可能与幽门螺杆菌血清阳性儿童中铁调素水平升高有关。需要进一步研究以阐明铁调素的作用。
