Dewan Pooja, Dixit Anupriya, Gomber Sunil, Kotru Mrinalini, Banerjee Basu D, Tyagi Vipin, Malhotra Rajeev K
Departments of Pediatrics.
Pathology.
J Pediatr Hematol Oncol. 2019 May;41(4):e216-e220. doi: 10.1097/MPH.0000000000001320.
Bone marrow iron estimation remains the gold standard for diagnosing iron-deficiency anemia (IDA); serum ferritin, total iron-binding capacity, and transferrin saturation are routinely used as surrogate markers of IDA. However, these tests are marred by problems like poor specificity and sensitivity. Recently, hepcidin, a protein hormone synthesized in the liver and excreted in urine, has been shown to be related to iron status. We estimated the serum and urinary hepcidin levels in healthy children 6 to 60 months of age with (n=30) and without IDA (n=30). The mean (SD) serum hepcidin levels in children with IDA were significantly lower than those in children without IDA (3.03 [1.06] vs. 4.78 [3.94] ng/mL; P=0.02). The mean (SD) urinary hepcidin levels were also significantly lower in children with IDA than those in children without IDA (2.29 [0.53] vs. 2.79 [0.75] ng/mL; P=0.004). Performance of urinary and serum hepcidin compared with serum ferritin (<12 µg/L) for diagnosing IDA in terms of area under the receiver operating characteristic curve was 0.704 (P=0.007) and 0.59 (P=0.22), respectively. Serum hepcidin is not useful for diagnosing IDA in under-5 children. In contrast, urinary hepcidin holds promise as a noninvasive diagnostic tool for IDA in under-5 children.
骨髓铁含量测定仍是诊断缺铁性贫血（IDA）的金标准；血清铁蛋白、总铁结合力和转铁蛋白饱和度常被用作IDA的替代标志物。然而，这些检测存在特异性和敏感性差等问题。最近，铁调素，一种在肝脏合成并经尿液排泄的蛋白质激素，已被证明与铁状态有关。我们评估了6至60个月健康儿童（有IDA的30名，无IDA的30名）的血清和尿铁调素水平。IDA患儿的平均（标准差）血清铁调素水平显著低于无IDA的患儿（3.03[1.06]对4.78[3.94]ng/mL；P=0.02）。IDA患儿的平均（标准差）尿铁调素水平也显著低于无IDA的患儿（2.29[0.53]对2.79[0.75]ng/mL；P=0.004）。在诊断IDA方面，尿和血清铁调素与血清铁蛋白（<12µg/L）相比，受试者工作特征曲线下面积分别为0.704（P=0.007）和0.59（P=0.22）。血清铁调素对诊断5岁以下儿童的IDA无用。相比之下，尿铁调素有望成为诊断5岁以下儿童IDA的非侵入性诊断工具。
