High serum hepcidin is associated with the occurrence of anemia in anti-myeloperoxidase antibody-associated vasculitis with normal kidney function: a cross-sectional study.

Abstract

The etiology of anemia in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) has not been elucidated. In this cross-sectional study, we tried to investigate the relationship between serum hepcidin and anemia in myeloperoxidase (MPO)-ANCA-AAV. Data of 64 newly diagnosed AAV patients who did not have kidney dysfunction or hemorrhage were analyzed. Serum hepcidin was measured with enzyme linked immunosorbent assay. Twenty-three of 64 patients had anemia. Compared with patients without anemia, patients with anemia had higher Birmingham vasculitis activity score [10 (3, 23) vs. 5 (3, 17), p = 0.020], lower levels of serum iron (5.83 ± 1.63 vs. 9.76 ± 1.54, p < 0.001) and higher levels of ferrtin [358.00 (59.85, 1314.10) vs. 151.05 (43.00, 645.30), p = 0.006]. All 64 patients had increased levels of serum hepcidin compared with normal controls, while patients with anemia had higher serum hepcidin than patients without anemia (85.30 ± 16.92 ng/mL vs. 53.48 ± 13.32 ng/mL, p < 0.001). In the multivariable analysis, the level of hemoglobin correlated with the levels of serum iron (r = 0.344, p = 0.026) and hepcidin (r = - 0.353, p = 0.022). Low level of serum iron was related to high level of serum hepcidin (r = - 0.472, p = 0.001). Immunosuppressive treatment induced rapid decrease of hepcidin and increase of serum iron on the 1st month, while the recovery of hemoglobin was relatively slow. This study indicated that in MPO-AAV without kidney dysfunction or hemorrhage, the existence of anemia is associated with high level of hepcidin which induces low serum iron and the abnormality of iron utilization.

• Authors: Tong Chen, Peng-Cheng Xu, Shui-Yi Hu, Shan Gao, Jun-Ya Jia, Tie-Kun Yan
• Journal: Rheumatology international (Rheumatol Int) Vol. 39 Issue 5 Pg. 851-857 (05 2019) ISSN: 1437-160X [Electronic] Germany
• PMID: 30923957 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Hepcidins
• Peroxidase

Topics

• Aged
• Aged, 80 and over
• Anemia (blood, complications)
• Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis (blood, complications, immunology)
• Cross-Sectional Studies
• Female
• Hepcidins (blood)
• Humans
• Male
• Middle Aged
• Peroxidase (immunology)