The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.
Department of Obstetrics and Gynecology, Dongguan People's Hospital of Southern Medical University, Dongguan, China.
Br J Haematol. 2022 Jan;196(2):390-396. doi: 10.1111/bjh.17827. Epub 2021 Sep 25.
In patients with beta-thalassaemia intermedia or major, hepcidin induces iron overload by continuously promoting iron absorption. There have been no studies in pregnant women with beta-thalassaemia minor combined with iron deficiency anaemia (IDA), examining whether hepcidin is inhibited by GDF15, as may occur in patients with beta-thalassaemia intermedia or major, or whether the iron metabolism characteristics and the effect of iron supplementation are consistent with simple IDA in pregnancy. We compared and analysed routine blood parameters, iron metabolism parameters, the GDF15 levels, and the hepcidin levels among four groups, namely the beta-thalassaemia (β) + IDA, β, IDA, and normal groups. In addition, the β + IDA and IDA groups received iron supplementation for four weeks. We found no statistically significant correlation between hepcidin and GDF15 in any group, but a positive correlation was observed between hepcidin and ferritin. After iron supplementation, the routine blood parameters and iron metabolism parameters in the β + IDA group were improved, and the hepcidin content was significantly increased. These results suggest that in pregnant women with beta-thalassaemia minor, hepcidin functions normally to maintain iron homeostasis, and that iron supplementation is effective and safe.
在β-地中海贫血中间型或重型患者中,铁调素通过持续促进铁吸收导致铁过载。尚未有研究探讨β-地中海贫血轻型伴缺铁性贫血(IDA)的孕妇中,铁调素是否像β-地中海贫血中间型或重型患者那样受到 GDF15 的抑制,以及铁代谢特征和铁补充的效果是否与妊娠单纯 IDA 一致。我们比较和分析了四组人群(β-地中海贫血(β)+ IDA、β、IDA 和正常组)的常规血液参数、铁代谢参数、GDF15 水平和铁调素水平。此外,β+IDA 和 IDA 组接受了四周的铁补充治疗。我们发现,各组之间铁调素与 GDF15 之间均无统计学显著相关性,但铁调素与铁蛋白之间呈正相关。铁补充治疗后,β+IDA 组的常规血液参数和铁代谢参数得到改善,铁调素含量显著增加。这些结果表明,在β-地中海贫血轻型的妊娠妇女中,铁调素正常发挥作用以维持铁稳态,且铁补充治疗是有效且安全的。