P1375ORAL VITAMIN C EFFECT ON HEPCIDIN LEVEL IN HAEMODIALYSIS PATIENTS WITH FUNCTIONAL IRON DEFICIENCY ANAEMIA

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Maha Abdelmoneim Behairy Said ◽  
Reem Elsharabasy ◽  
Ahmed Gharib ◽  
Mahmoud Zaki
Keyword(s):  
Iron Deficiency ◽  
Vitamin C ◽  
Deficiency Anemia ◽  
Control Group ◽  
Study Group ◽  
Oral Vitamin ◽  
Functional Iron Deficiency ◽  
Hepcidin Level ◽  
Serum Hepcidin ◽  
The Mean

Abstract Background and Aims Hepcidin is a key regulatory peptide in iron homeostasis, inhibiting iron absorption by binding to ferroportin. Inflammatory mediated increase in hepcidin levels and reduced clearance in hemodialysis (HD) patients lead to functional iron deficiency ( FID) and Erythropoiesis-stimulating agent (ESA) resistance. Ascorbic acid (Vitamin C) may be used as adjuvant therapy in FID anemia through its anti-inflammatory and anti-oxidant nature, but there was limited studies investigating the direct relation between vitamin C and hepcidin level in HD patients. We Aimed to test the reducing therapeutic effect of oral vitamin C supplement on hepcidin level among hemodialysis patients with functional iron deficiency anaemia. Method This study is an open label randomized controlled clinical trial that was conducted in hemodialysis units of Ain Shams University hospitals, 48 prevalent HD patients with mean age of 46.48 ± 15.57 years were included ,Group 1 (study group) :31 patients [13(41.9%) males & 18(58.1%) females] who received the conventional treatment of erythropoietin stimulating agents together with oral supplementation of vitamin C 500 mg every other day dose for 3 months. Group 2 (control group): included 17 patients [8(47.1%) males and 9 (52.9%) females] who received only the conventional therapy of erythropoietin stimulating agents according to their Hb levels. The patients enrolled in the study were patients on regular conventional HD for more than 6 months with functional iron deficiency anemia, defined as: hemoglobin level <11 gm/dl, ferritin level >200 ng/ml and TSAT >20 %. Patients with history of non-renal causes of anemia including malignancy, end-stage liver disease, or chronic hypoxia, patients with evidence of active or occult bleeding, patients who received blood transfusion within the last 4 months, history of recent hospitalization or infection requiring antibiotics within the last 4 weeks and patients with evidenced iron deficiency anemia were all excluded from the study .Laboratory parameters including serum hepcidin level, highly sensitive CRP (hsCRP) titer, CBC, kidney function tests and iron indices were measured at baseline and after 3 months . Results Oral vitamin C supplementation in Group 1(study group) resulted in statistically significant reduction in Hepcidin levels in the study group [mean 2506.45± 1320.53 pg/ml to 1748.39 ±1432.28 pg/ml ](P=0.03), and highly significant reduction in hsCRP level [mean 8603.23 ±2547.77 ng/ml to 5611.29 ±2829.27 ng/ml](P=0.001) after 3months of treatment. On comparing the two groups regarding changes in Hepcidin levels during follow up, illustrates that vitamin C together with time resulted in significant reduction of hepcidin levels in the study group (P<0.05) by repeated measure ANOVA test (Figure 1). Comparison between the two groups regarding change in hsCRP levels during follow up showed there was a highly significant change in the mean hsCRP over time, and the mean hsCRP differed significantly between the two groups (Figure 2). A significant reduction in serum iron and ferritin levels was observed in study group after treatment vitamin C but the change of the mean of S. ferritin level didn’t differ significantly in comparison to control group . Decreased EPO requirements and elevation of hemoglobin level were observed in the study group but without a statistical significance compared to the control group, this might be attributed to the short period of vit C supplementation. There was a highly significant correlation between serum hepcidin and hsCRP (r=0.46, P<0.01) . Conclusion : Oral Vitamin C may be promising therapy in decreasing serum hepcidin and hsCRP in prevalent hemodialysis patients with functional iron deficiency anemia.

Effects of Oral Vitamin C on Hepcidin Levels and Erythropoietin Requirements in Functional Iron Deficiency Anemia among Hemodialysis Patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mahmoud Mohamed Zaki Ali ◽  
Maha Abd ElMoniem Behairy ◽  
Reem Mohsen El Sharabasy ◽  
Ahmed Hamed Ahmed Gharib
Keyword(s):  
Iron Deficiency ◽  
Vitamin C ◽  
Iron Deficiency Anemia ◽  
Hemodialysis Patients ◽  
Deficiency Anemia ◽  
Study Group ◽  
Oral Vitamin ◽  
Functional Iron Deficiency ◽  
Serum Hepcidin ◽  
Hs Crp

Abstract Background Hepcidin has long been postulated as a key regulatory peptide in iron homeostasis. Its reduced clearance and elevated levels in hemodialysis (HD) patients lead to functional iron deficiency (FID) and ESA resistance. Vitamin C may be used as adjuvant therapy in FID anemia, but there are limited studies investigating the direct relation between vitamin C and hepcidin levels in HD patients. We aimed to test the reducing effect of Oral vitamin C therapy on hepcidin levels among hemodialysis patients with functional iron deficiency anemia. Patients and Methods This study is an open label randomized controlled clinical trial. It was conducted in the hemodialysis units of Ain Shams University hospitals. 48 adult prevalent HD patients were included and were divided into two groups. Group 1 (study group) included 31 patients who received the conventional treatment of erythropoietin stimulating agents (ESAs) together with oral supplementation of vitamin C 500 mg every other day for 3 months in addition to IV iron therapy. Group 2 (control group) included 17 patients who received only the conventional therapy of ESAs according to their hemoglobin (Hb) levels in addition to IV iron therapy. Laboratory parameters including serum hepcidin levels, highly sensitive CRP (hs-CRP) titer, CBC, kidney function tests and iron indices were measured at the baseline of the study and after 3 months. Results Oral vitamin C therapy resulted in a statistically significant reduction in both hepcidin and hs-CRP levels in the study group after 3 months. The study group showed a significant reduction in serum iron and ferritin levels (P < 0.05). A Decrease in EPO requirements and elevation of hemoglobin level were observed in the study group but were not statistically significant as a short term effect of oral vitamin C, in comparison to the control group. A highly significant correlation was observed between serum hepcidin and hs-CRP (R=0.46, P<0.01). Conclusion Oral vitamin C may be a promising therapy in decreasing serum hepcidin and hs-CRP levels in prevalent hemodialysis patients with functional iron deficiency anemia.

scholarly journals Effect of oral vitamin C on serum hepcidin level, iron status and inflammation among hemodialysis patients with functional iron deficiency anaemia

2021 ◽  
Vol 7 (1) ◽  
pp. e16-e16
Author(s):  
Maha A. Behairy ◽  
Ahmed Gharib ◽  
Mahmoud Zaki ◽  
Reem El Sharabasy
Keyword(s):  
Iron Deficiency ◽  
Vitamin C ◽  
Iron Status ◽  
Hemoglobin Level ◽  
Control Group ◽  
Oral Vitamin ◽  
Functional Iron Deficiency ◽  
Serum Hepcidin ◽  
Hs Crp ◽  
Erythropoietin Stimulating Agents

Introduction: Hepcidin is a key regulatory peptide in iron homeostasis, the pathogenesis of functional iron deficiency (FID) anemia and erythropoiesis-stimulating agent (ESA) resistance is contributed to the inflammatory mediated increase in the serum hepcidin levels among prevalent hemodialysis (HD) patients. Objectives: To test the reducing therapeutic effect of oral vitamin C supplements on hepcidin levels and iron status among HD patients with FID anemia. Patients and Methods: This study is an interventional prospective cohort study; 48 prevalent HD patients were enrolled. Group one: 31 patients who received the conventional treatment of erythropoietin stimulating agents together with oral supplementation of vitamin C 500 mg every other day dose for 3 months. Group two: 17 patients who received only the conventional therapy of erythropoietin stimulating agents. Patients with hemoglobin level <11 g/dL, ferritin level >200 ng/mL and transferrin saturation (TSAT) >20 % were included. Laboratory parameters: serum hepcidin, high-sensitivity C-reactive protein (hs-CRP) titre, CBC, and iron indices were measured at baseline and after 3 months. Results: On comparing the two groups, oral vitamin C in group 1 resulted in a statistically significant reduction in hepcidin levels [mean 2506.456 ± 1320.53 pg/mL to 1748.396 ± 1432.28 pg/mL (P = 0.03)], and a significant reduction in hs-CRP level [mean 8603.236 ± 2547.77 ng/mL to 5611.296 ± 2829.27 ng/mL] (P = 0.001) after three months of treatment in comparison to control group. A decrease of EPO requirement and elevation of hemoglobin level were observed in a study group with oral vitamin C. Conclusion: Oral vitamin C may be a promising therapy in decreasing serum hepcidin and inflammatory markers among prevalent HD patients with FID anemia.

scholarly journals Serum Concentration of Hepcidin as an Indicator of Iron Reserves in Children

2018 ◽  
Vol 37 (4) ◽  
pp. 456-464 ◽  
Author(s):  
Jelena Ćulafić ◽  
Jovanka Kolarović ◽  
Lato Pezo ◽  
Velibor Čabarkapa ◽  
Stanislava Nikolić ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Serum Concentration ◽  
Iron Deficiency Anemia ◽  
Iron Metabolism ◽  
Transferrin Saturation ◽  
The Body ◽  
Deficiency Anemia ◽  
Control Group ◽  
Hepcidin Level ◽  
Serum Hepcidin

SummaryBackground:Anemia represents a significant cause of maternal and perinatal mortality, as well as child mortality. The aim of the research was to determine the serum concentration of hepcidin in children aged 6 months to 2 years and adolescents aged 11 to 19 years which suffer from iron deficiency anemia and compare it with the serum concentration of hepcidin in the control groups, as well as to determine its connection with the parameters of the iron metabolism.Methods:The research included 173 examinees, 89 of them suffered from iron deficiency anemia and 84 did not suffer from iron deficiency anemia (the latter represented the control group). Blood samples were collected from all study participants. The samples were analyzed for complete blood count and parameters of iron metabolism. ELISA method was used for establishing serum hepcidin levels.Results:The research showed that the concentration of hepcidin is statistically lower in children (4.4 ng/mL) and adolescents (4.1 ng/mL) who suffer from iron deficiency anemia in comparison with the control group (14 ng/mL, 10 ng/mL, respectively). The positive correlation between serum hepcidin level and iron in the serum, ferritin, the mean corpuscular volume and transferrin saturation was confirmed, but the negative one occurred in serum hepcidin level, transferrin and reticulocytes.Conclusions:The age of the examinees does not influence the level of serum hepcidin which makes it a more sensitive indicator of the level of iron in the body. Besides this, serum hepcidin is a reliable biological marker for the assessment of iron deficiency anemia.

scholarly journals ALTERED IRON METABOLISM IN SUBCLINICAL HYPOTHYROIDISM: MYTH OR REALITY

2019 ◽  
Vol 3 (8) ◽  
Author(s):  
Yan Naing Soe ◽  
Bhasker Mukherjee ◽  
H S Batra ◽  
Sibin M K ◽  
Pratibha Misra ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Metabolism ◽  
Subclinical Hypothyroidism ◽  
Hormone Deficiency ◽  
Deficiency Anemia ◽  
Control Group ◽  
Study Group ◽  
Early Management ◽  
High Prevalence ◽  
Iron Profile

Introduction: Subclinical hypothyroidism refers to thyroid hormone deficiency in patients who have no apparent clinical features. Both iron deficiency anemia and subclinical hypothyroidism, due to their high prevalence and close interrelation, are significant clinical problems. Aims and Objectives: Association of subclinical hypothyroidism and disordered iron metabolism was studied so that better management of iron deficiency could be advised in these patients. Materials and Methods: 150 newly diagnosed subclinical hypothyroid patients and 150 healthy euthyroid controls were included. Total T3, total T4, TSH, iron, TIBC, transferrin and ferritin were measured. Data was analysed by student‘t’ test and Person’s formula. Results: Mean total T3, total T4, iron, TIBC, transferrin and ferritin values of study group were lower than that of control group (p < 0.05). Mean TSH values of study group was higher than that of control group (p < 0.05). Total T4 and T3 were positively correlated with transferrin (p < 0.05). The patients of subclinical hypothyroidism had altered iron metabolism. Conclusion: Decreased iron profile in subclinical hypothyroidism was significantly high. It was suggestive to regularly investigate iron profile for early detection and its early management in case of subclinical hypothyroidism. Keywords: Subclinical Hypothyroidism, Serum Iron, TIBC, Ferritin, Transferrin

scholarly journals Serum Hepcidin Level in Obese Children and Adolescents: It’s Association with Iron Deficiency Anemia

2021 ◽  
pp. 77-88
Author(s):  
Mahmoud Ibrahim El Nashar ◽  
Rasha Mohamed Gamal EL-Shafiey ◽  
Mohammed Attia Saad ◽  
Mohammed Amr Hamam
Keyword(s):  
Iron Deficiency ◽  
Children And Adolescents ◽  
Iron Deficiency Anemia ◽  
Deficiency Anemia ◽  
Healthy Children ◽  
Obese Children ◽  
Hepcidin Level ◽  
Significant Difference ◽  
Serum Hepcidin ◽  
Iron Profile

Background: Childhood obesity is a worldwide chronic public health problem. It was found that obesity is associated with iron deficiency and iron profile abnormalities, which appear to be caused by several factors such as decreased intake, insufficient bioavailability, and deficient intestinal iron uptake as well as iron release from stores because of an over expression of hepcidin. Aim of the Work: Was to estimate serum hepcidin levels in obese children and adolescents and to evaluate its relation with iron deficiency anemia in these children. Subjects and Methods: The current study included 50 patients recruited from the Nutrition Clinic of Pediatric Department at Tanta University Hospital, 25 of them were obese with iron deficiency anemia and the other 25 were obese without iron deficiency anemia and 25 healthy children and adolescents of matched age and sex enrolled as controls. All studied children were subjected to complete history taking, thorough clinical examination including anthropometric measures (Weight, height, Body mass index), assessment of pubertal status using Tanner criteria and laboratory investigations including: CBC, BUN, creatinine, ALT, AST, stool analysis, occult blood in stool, CRP, iron profile, Serum Hepcidin, abdominal ultrasound. Results: There were significant differences between patients and control group as regard Weight, BMI and their z scores. Significantly lower levels of hemoglobin, serum ferritin, serum iron and transferrin saturation in obese children with IDA than obese children without IDA and controls and significantly higher levels of TIBC were found in obese children with IDA compared to obese children without IDA and controls. As regard CRP it was significantly higher in obese children than controls. Serum hepcidin was significantly higher in obese children than controls but there is no significant difference between obese children with IDA and obese children without IDA. Significant positive correlation between Serum hepcidin levels and BMI in obese children was found. Conclusion: Serum hepcidin level was significantly higher in obese children and adolescents in comparison with healthy lean control with no significant difference between obese children with IDA and obese children without IDA. So, estimation of serum hepcidin level is not diagnostic but it may be beneficial in screening of iron deficiency anemia in pediatric obese individuals. Further studies with larger sample size are needed to verify these findings.

scholarly journals Comparative Characteristics Of Ferrokinetic Parameters And Their Relationship With Inflammation In Patients With CHF In Advanced And Senile Age

2021 ◽  
Vol 03 (04) ◽  
pp. 142-149
Author(s):  
Akhmedova N.Sh. ◽  
Keyword(s):  
Heart Failure ◽  
Iron Deficiency ◽  
Acute Phase ◽  
Acute Phase Proteins ◽  
Deficiency Anemia ◽  
Control Group ◽  
C Reactive Protein ◽  
Anemia Of Chronic Disease ◽  
Functional Iron Deficiency ◽  
Reactive Protein

To perform a comparative analysis of anemia of chronic disease (ACD) and iron-deficiency anemia (IDA) in late middle-aged and elderly patients with chronic heart failure (CHF) by ferrokinetic parameters, inflammation indexes, and their associations. Materials and methods. 65 patients with ischemic heart disease were evaluated, including 35 patients with CHF and ACD, 10 patients with CHF and IDA, and 20 patients without CHF, ACD, and IDA (control group, CG). Results. Patients with CHF and IDA had true iron deficiency whereas 54% of patients with CHF and ACD had functional iron deficiency, and 46% of patients had no iron deficiency. Levels of acute phase proteins, ferritin and hepcidin, C-reactive protein (CRP), and interleukin-6 (IL-6) were highly significantly different in patients with CHF and ACD and patients with CHF and IDA; positive and significant correlations were found for levels of IL-6 and ferritin, IL-6 and CRP, and CRP and hepcidin. In patients with CHF and IDA, levels of acute phase proteins, ferritin and hepcidin, CRP, and IL-6 were low and correlations of IL-6 with ferritin, IL-6 with CRP, and CRP with hepcidin were non-significant. Concentrations of erythropoietin were significantly higher in patients with CHF and ACD and patients with CHF and IDA compared to the control group; however, significant differences between them were absent.

scholarly journals Relationship between iron metabolism and thyroid hormone profile in hypothyroidism

2021 ◽  
Vol 9 (3) ◽  
pp. 790
Author(s):  
Suman Chatterjee ◽  
Phalguni Chakrabarti ◽  
Prasanta Sinhamahapatra
Keyword(s):  
Thyroid Hormone ◽  
Iron Deficiency ◽  
Serum Ferritin ◽  
Iron Metabolism ◽  
Negative Correlation ◽  
Control Group ◽  
Thyroid Peroxidase ◽  
Study Group ◽  
The Mean ◽  
Serum Tsh

Background: Iron and thyroid hormone metabolism are closely related with each other. Iron plays an important role for both the synthesis as well as metabolism of thyroid hormones acting as a component of many enzymes including thyroid peroxidase (TPO). So, iron deficiency can lead to abnormal functioning of thyroid gland. Ferritin is storage form of iron in our body. Several studies in showed that nutritional iron deficiency can significantly decrease the circulating levels of both T4 and T3 and it can also reduce peripheral conversion of T4 to T3. So, the aim of the study is to find out whether there is any relationship between hypothyroidism and iron metabolism.Methods: This cross-sectional descriptive study was conducted at Deben Mahata Government Medical College and Hospital, Purulia on 50 hypothyroid patients and 50 age and sex matched controls after imposing inclusion and exclusion criterias. Blood samples were collected and estimation of Serum TSH, fT4 and fT3, iron, ferritin and TIBC levels were done. Then the data obtained were analysed by proper statistical methods.Results: Out of 100 subjects 68 were male and rest were female. The mean serum TSH level in study population was significantly higher than that of comparison group. While serum fT3 and fT4 level in study group were lower than the control group and both were statistically significant. In the other hand, the mean serum ferritin and iron levels in cases were lower than that in controls and the mean TIBS was higher in study group and all the differences were statistically significant. There were significant correlation between Serum ferritin and serum iron (positive correlation), Serum ferritin and TSH (negative correlation), Serum TSH and fT4 (negative correlation) but there was no significant relationship between serum TSH and iron.Conclusions: The iron metabolism is disturbed in hypothyroidism reflected by low serum ferritin and iron.

Decreased Hepcidin Level in Iron Deficiency Anemia after Successful Helicobacter pylori Eradication Therapy: A Preliminary Data.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 2678-2678
Author(s):  
Yo-Han Cho ◽  
Sun-Young Lee ◽  
Eun Young Song ◽  
Yeo Min Yun ◽  
So Young Yoon ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Binding Capacity ◽  
Eradication Therapy ◽  
Deficiency Anemia ◽  
Hepcidin Level ◽  
Serum Hepcidin ◽  
H Pylori ◽  
Iron Binding Capacity

Abstract Background/Aim: Hepcidin, a hepatic antimicrobial protein, is usually over-expressed in iron deficiency anemia. However, whether gastric Helicobacter pylori (H. pylori) infection effects a change in hepcidin level in iron deficiency anemia is still uncertain. We evaluated whether H. pylori eradication decreased hepcidin level and increased hemoglobin and ferritin levels in iron deficiency anemia. Method: From October 2006 to April 2007, nine females (mean age of 32.2 year-old) who were diagnosed as iron deficiency anemia without definite blood loss, were included in the study. All the subjects underwent upper gastrointestinal endoscopy and colonoscopy to diagnose gastric H. pylori infection and to exclude any source of gastrointestinal bleeding. Blood samplings for hemoglobin, hematocrit, iron (Fe), total iron binding capacity (TIBC), ferritin and hepcidin tests were taken just before H. pylori eradication and four weeks after H. pylori eradication and oral iron supplement therapy, respectively. Serum prohepcidin level was measured by Hepcidin Prohormone ELISA (Solid Phase Enzyme-Linked Immunosorbent Assay) kits. Statistical analysis was done by Wilcoxon signed rank test. Result: H. pylori eradication was successful in all the subjects who revealed negative in urea breath test. Hemoglobin, hematocrit, Fe, TIBC and ferritin levels improved in all the subjects after H. pylori eradication (Table 1). Mean serum hepcidin level was 224.8 ± 23.2 ng/ml initially, but decreased to 179.7 ± 40.8 ng/ml after H. pylori eradication therapy (p = 0.015). Conclusion: Our result provides evidence that hepcidin level decreases after successful H. pylori eradication with the improvement of iron deficiency anemia. A fall in serum hepcidin level resulting from successful H. pylori eradication reflects that hepcidin is an important mediator of iron absorption in iron deficiency anemia associated with gastric H. pylori infection. Table 1. Results of blood tests before and after Helicobacter pylori eradication Before H. pylori eradication After H. pylori eradication p-value* *Wicoxon signed ranks test Fe, iron; TIBC, total iron binding capacity Hemoglobin (g/dl, mean ± SD) 7.67 ± 2.01 10.76 ± 2.43 0.008 Hematocrit (%, mean ± SD) 26.36 ± 5.76 34.26 ± 5.76 0.008 Fe (ug/dl, mean ± SD) 11.78 ± 4.21 45.00 ± 54.39 0.038 TIBC (ug/dl, mean ± SD) 480.78 ± 51.39 427.00 ± 66.30 0.008 Ferritin (ng/ml, mean ± SD) 2.67 ± 0.99 7.39 ± 6.38 0.021 Hepcidin (ng/ml, mean ± SD) 224.80 ± 23.23 179.70 ± 40.84 0.015

Sign in / Sign up

Export Citation Format

Share Document