Division of Nutritional Sciences, Cornell University, Ithaca, NY.
The University of Rochester School of Medicine, Rochester, NY.
J Nutr. 2018 Nov 1;148(11):1716-1722. doi: 10.1093/jn/nxy151.
Hepcidin is a systemic regulator of iron homeostasis. Little is known about the relative role of maternal compared with cord hepcidin on neonatal iron homeostasis.
This study was undertaken to evaluate inter- and intrauterine variance in neonatal iron status, vitamin B-12, folate, and inflammatory markers in a cohort of twins (n = 50), triplets (n = 14), and quadruplets (n = 1) born to 65 women.
Umbilical cord blood was obtained from 144 neonates born at 34.8 ± 2.7 wk of gestation with a mean birth weight of 2236 ± 551 g (means ± SDs). Cord hemoglobin and cord serum measures of ferritin (SF), soluble transferrin receptor (sTfR), hepcidin, erythropoietin (EPO), iron, vitamin B-12, folate, interleukin 6, and C-reactive protein were evaluated.
Intraclass correlation coefficient (ICC) analyses were used to examine inter- and intrauterine variance in neonatal iron indicators. A greater variability in cord hepcidin (ICC = 0.39) was found between siblings. Cord hepcidin had the greatest association with cord iron indicators because cord hepcidin alone captured 63.8%, 48.4%, 44.4%, and 31.3% of the intrauterine variance in cord hemoglobin, SF, sTfR, and EPO, respectively, whereas maternal hepcidin had no effect on cord iron indicators. Significantly greater differences in cord SF (P = 0.03), sTfR (P = 0.03), hepcidin (P = 0.0003), and EPO (P = 0.03) were found between di- and trichorionic siblings than between monochorionic siblings. In contrast, cord folate (ICC = 0.79) and vitamin B-12 (ICC = 0.74) exhibited a greater variability between unrelated neonates.
In summary, fetally derived hepcidin might have more control on intrauterine variance in iron indicators than maternal hepcidin and appears to be capable of regulating fetal iron status independently of maternal hepcidin. The use of a multiple-birth model provides a unique way to identify factors that may contribute to placental nutrient transport and iron stores at birth.
铁调素是铁稳态的系统调节剂。关于母体铁调素与脐带铁调素对新生儿铁稳态的相对作用，人们知之甚少。
本研究旨在评估 65 名孕妇所生的 50 对双胞胎、14 对三胞胎和 1 对四胞胎（n=144）新生儿的铁状态、维生素 B12、叶酸和炎症标志物的宫内和宫内变异性。
在妊娠 34.8±2.7 周时采集 144 名新生儿的脐带血，平均出生体重为 2236±551g（平均值±标准差）。评估脐带血血红蛋白和血清铁蛋白（SF）、可溶性转铁蛋白受体（sTfR）、铁调素、促红细胞生成素（EPO）、铁、维生素 B12、叶酸、白细胞介素 6 和 C 反应蛋白。
使用组内相关系数（ICC）分析来检查新生儿铁指标的宫内和宫内变异性。发现兄弟姐妹之间脐带铁调素的变异性更大（ICC=0.39）。脐带铁调素与脐带铁指标的相关性最大，因为单独的脐带铁调素分别解释了脐带血红蛋白、SF、sTfR 和 EPO 中 63.8%、48.4%、44.4%和 31.3%的宫内变异性，而母体铁调素对脐带铁指标没有影响。双绒毛膜和三绒毛膜兄弟姐妹之间的脐带 SF（P=0.03）、sTfR（P=0.03）、铁调素（P=0.0003）和 EPO（P=0.03）差异显著，而单绒毛膜兄弟姐妹之间的差异不显著。相比之下，脐带叶酸（ICC=0.79）和维生素 B12（ICC=0.74）在无亲缘关系的新生儿之间的变异性更大。
总之，胎儿来源的铁调素可能比母体铁调素对铁指标的宫内变异性有更大的控制作用，并且似乎能够独立于母体铁调素调节胎儿铁状态。多胎模型的使用提供了一种独特的方法来识别可能有助于胎盘营养转运和出生时铁储存的因素。
