Correlation of hepcidin and serum ferritin levels in thalassemia patients at Chiang Mai University Hospital

Abstract

Hepcidin is a key iron-regulatory hormone, the production of which is controlled by iron stores, inflammation, hypoxia and erythropoiesis. The regulation of iron by hepcidin is of clinical importance in thalassemia patients in which anemia occurs along with iron overload. The present study aimed to evaluate the correlation between serum hepcidin and ferritin levels in thalassemia patients. This cross-sectional study investigated 64 patients with thalassemia; 16 β-thalassemia major (BTM), 31 β-thalassemia/hemoglobin (Hb) E (BE), and 17 Hb H + AE Bart's disease (Hb H + AE Bart's). The levels of serum hepcidin and ferritin, and Hb of the three groups were measured. The median values of serum ferritin and Hb were significantly different among the three groups, whereas serum hepcidin values were not observed to be significantly different. The correlation of the serum hepcidin and ferritin levels was not statistically significant in any of the three groups of thalassemia patients with BTM, BE, or Hb H + AE Bart's (r = -0.141, 0.065 and -0.016, respectively). In conclusion, no statistically significant correlations were observed between serum hepcidin with any variables including serum ferritin, Hb, age, labile plasma iron (LPI), and number of blood transfusion units among the three groups of thalassemia patients. Likely, the regulation of hepcidin in thalassemia patients is affected more by erythropoietic activity than iron storage.

Keywords: Hb H disease; ferritin; hepcidin; β-thalassemia major; β-thalassemia/Hb E.

Figure 1. The correlation between serum hepcidin and serum ferritin

(A) Linear correlation between serum hepcidin and serum ferritin levels in all thalassemia patients (R² = 0.032). (B) Linear correlation between serum hepcidin and serum ferritin levels in TDT (R² = 0.1949) and NTDT (R² = 0.0168) patients.