Department of Pediatrics, Dana Dwek Children's Hospital, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Pediatric Gastroenterology Unit, Dana Dwek Children's Hospital, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
J Crohns Colitis. 2019 Sep 27;13(10):1287-1291. doi: 10.1093/ecco-jcc/jjz056.
The role of hepcidin in inflammatory bowel disease [IBD] in children with anaemia is poorly understood. However, it has been shown that vitamin D suppresses hepcidin expression. We aimed to assess serum hepcidin levels and the effect of vitamin D treatment on those levels in newly diagnosed IBD paediatric patients.
Eighty-five children were prospectively recruited in the Dana-Dwek Children's Hospital [40 newly diagnosed IBD, 45 healthy controls, 47% female, mean age 13.5 ± 3.4 years]. Blood samples for measurement of interleukin 6 [IL-6], C-reactive protein [CRP], hepcidin, iron parameters and 25-hydroxyvitamin D [25-(OH)-D] levels were obtained at baseline. Patients with mild-to-moderate signs and symptoms of IBD were treated with 4000 units of vitamin D daily for 2 weeks, after which the blood tests were repeated.
Basal hepcidin, IL-6, CRP and platelet counts were significantly higher, and haemoglobin, serum iron and transferrin levels were significantly lower in the IBD children compared to controls [p < 0.001]. Eighteen patients completed 2 weeks of treatment with vitamin D. Following treatment, serum 25-(OH)-D concentrations increased by 40% [from 22.5 to 32.5 ng/mL], and serum hepcidin, CRP and ferritin levels decreased by 81%, 81% and 40% [from 33.9 to 6.7 ng/mL, from 23.9 to 4.7 mg/L, and from 27 to 16 ng/mL, respectively] [p ≤ 0.001].
Serum hepcidin levels were significantly higher in IBD paediatric patients compared to controls. Following vitamin D treatment, serum hepcidin concentration decreased significantly. These findings suggest a potential role for vitamin D in treating anaemia in IBD children.
CLINICALTRIALS.GOV NUMBER: NCT03145896.
铁调素在儿童贫血性炎症性肠病（IBD）中的作用尚未完全阐明。然而，已有研究表明维生素 D 可抑制铁调素的表达。本研究旨在评估新诊断的 IBD 患儿的血清铁调素水平，并评估维生素 D 治疗对其水平的影响。
前瞻性纳入达纳-德威克儿童医院 85 例患儿（40 例新诊断的 IBD，45 例健康对照，女性占 47%，平均年龄 13.5±3.4 岁）。基线时采集血液样本，用于检测白细胞介素 6（IL-6）、C 反应蛋白（CRP）、铁调素、铁参数和 25-羟维生素 D [25-(OH)-D] 水平。对于有轻中度 IBD 症状和体征的患儿，给予每日 4000 单位的维生素 D 治疗 2 周，然后重复血液检查。
与对照组相比，IBD 患儿的铁调素、IL-6、CRP 和血小板计数显著升高，血红蛋白、血清铁和转铁蛋白水平显著降低（均 p<0.001）。18 例患儿完成了 2 周的维生素 D 治疗。治疗后，血清 25-(OH)-D 浓度增加了 40%（从 22.5 增至 32.5ng/mL），血清铁调素、CRP 和铁蛋白水平分别降低了 81%、81%和 40%（从 33.9 降至 6.7ng/mL、从 23.9 降至 4.7mg/L、从 27 降至 16ng/mL，均 p≤0.001）。
与对照组相比，IBD 患儿的血清铁调素水平显著升高。经维生素 D 治疗后，血清铁调素浓度显著降低。这些发现提示维生素 D 在治疗 IBD 患儿贫血中可能具有一定作用。
NCT03145896。
