Serum Hepcidin and Iron Absorption in Pediatric Inflammatory Bowel Disease.

Background and aims: We sought to correlate hepcidin levels in Inflammatory Bowel Disease (IBD) children with disease activity, inflammatory markers and iron load test (ILT) and to compare IBD patients with celiac and healthy patients. Methods: One-hundred-forty-five subjects (50 IBD, 45 celiac patients and 50 healthy controls) were included in the study between December 2012 and June 2013. All patients underwent the following examinations: blood count, iron status, erythropoiesis parameters, serum hepcidin, C-reactive protein, and erythrocyte sedimentation rate. In order to evaluate the efficacy of iron absorption ILT was performed in IBD patients. Disease activity indexes, IBD duration, localization and therapy were also evaluated and a fecal sample for calprotectin collected. Results: Serum hepcidin was significantly higher in IBD patients with active disease compared with both celiac and healthy patients (p=0.005; p=0.003 respectively). In a multivariate logistic regression model, having a PCDAI/PUCAI≥30 resulted the only variable independently associated with a positive serum hepcidin [OR= 6.87; CI 95% 1.4-33, p=0.01)]. Patients with iron malabsorption (IM) showed higher values of ESR, CRP and hepcidin (p=0.02, p=0.001 and p=0.06, respectively). Eight out of 12 (66.7%) children with IM showed an active disease compared with 6/31 (19.3%) children with normal ILT (p=0.01). Hepcidin levels correlated negatively with ILT (r=-0.451, p=0.002,), and positively with ferritin and CRP (r=0.442, p=0.0001; r=0.243, p=0.009, respectively) Conclusions: Our study demonstrates that serum hepcidin is increased in IBD children with active disease and it is responsible for IM.

Background and Aims: We sought to correlate hepcidin levels in inflammatory bowel disease [IBD] children with disease activity, inflammatory markers, and iron load test [ILT] and to compare IBD patients with coeliac and healthy patients. Methods: Between December 2012 and June 2013, 145 subjects [50 IBD patients, 45 coeliac patients and 50 healthy controls] were included in the study. All patients underwent the following examinations: Blood count, iron status, erythropoiesis parameters, serum hepcidin, C-reactive protein [CRP], and erythrocyte sedimentation rate [ESR]. In order to evaluate the efficacy of iron absorption, ILT was performed in IBD patients. Disease activity indexes and IBD duration, localisation, and therapy were also evaluated, and a faecal sample for calprotectin collected. Results: Serum hepcidin was significantly higher in IBD patients with active disease compared with both coeliac and healthy patients [p = 0.005, p = 0.003 respectively]. In a multivariate logistic regression model, having a Paediatric Crohn's Disease Activity Index [PCDAI] / Paediatric Ulcerative Colitis Activity Index [PUCAI] ≥ 30 resulted in the only variable independently associated with a positive serum hepcidin (odds ratio [OR] = 6.87; 95% confidence interval [CI] 1.4-33, p = 0.01]]. Patients with iron malabsorption [IM] showed higher values of ESR, CRP, and hepcidin [p = 0.02, p = 0.001, and p = 0.06, respectively]. Eight out of 12 [66.7%] children with IM showed an active disease compared with 6/31 [19.3%] children with normal ILT [p = 0.01]. Hepcidin levels correlated negatively with ILT [r = -0.451, p = 0.002], and positively with ferritin and CRP [r = 0.442, p = 0.0001; r = 0.243, p = 0.009, respectively] Conclusions: Our study demonstrates that serum hepcidin is increased in IBD children with active disease and it is responsible for IM.