Department of Pediatrics, Dana Dwek Children Hospital and The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Department of Pediatric Gastroenterology, Dana Dwek Children Hospital and The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Pediatr Res. 2018 Jul;84(1):62-65. doi: 10.1038/s41390-018-0005-0. Epub 2018 May 23.
Hepcidin is a master regulator of iron metabolism. Recently, it has been shown that vitamin D suppresses hepcidin expression. Our hypothesis was that hepcidin levels inversely correlate with vitamin D levels in anemic children during acute infection.
A prospective study was performed on 90 patients (45 females, 45 males, mean age 7.3 ± 5 years) who were admitted to the pediatric ward. Sixty-two patients had infectious disease (32 with coexisting anemia, 30 without anemia), and 28 patients were hospitalized for noninfectious causes. Blood samples for IL-6, hepcidin, iron status parameters, and 25-hydroxyvitamin D (25-OHD) were obtained within 72 h after admission.
Serum concentrations of IL-6 and hepcidin were significantly higher and 25-OHD, iron, and transferrin were significantly lower in anemic children with infectious disease compared with controls. Children with a serum 25-OHD level < 20 ng/ml had significantly increased odds of having anemia than those with a level > 20 ng/ml (OR: 6.1, CI: 1.15-32.76). Correlation analyses found positive associations between hepcidin levels and ferritin (R = 0.47, P < 0.001) and negative associations between hepcidin and transferrin (R = 0.57, P < 0.001).
Higher IL-6 and lower 25-OHD levels may lead to higher hepcidin levels and subsequently to hypoferremia and anemia in children with acute infection.
铁调素是铁代谢的主要调节剂。最近，研究表明维生素 D 可抑制铁调素的表达。我们的假设是，在急性感染期间，贫血儿童的铁调素水平与维生素 D 水平呈负相关。
对 90 名患者（女 45 名，男 45 名，平均年龄 7.3±5 岁）进行了前瞻性研究，这些患者被收入儿科病房。62 名患者患有感染性疾病（32 名伴有贫血，30 名无贫血），28 名患者因非传染性疾病住院。在入院后 72 小时内采集血样，用于检测 IL-6、铁调素、铁状态参数和 25-羟维生素 D（25-OHD）。
与对照组相比，患有感染性疾病的贫血儿童血清中 IL-6 和铁调素浓度显著升高，而 25-OHD、铁和转铁蛋白浓度显著降低。血清 25-OHD 水平<20ng/ml 的儿童发生贫血的可能性明显高于水平>20ng/ml 的儿童（OR：6.1，95%CI：1.15-32.76）。相关性分析发现铁调素水平与铁蛋白呈正相关（R=0.47，P<0.001），与转铁蛋白呈负相关（R=0.57，P<0.001）。
较高的 IL-6 和较低的 25-OHD 水平可能导致铁调素水平升高，继而导致急性感染儿童发生低铁血症和贫血。
