Iron regulatory hormone hepcidin decreases in chronic heart failure patients with anemia.
BACKGROUND
The etiology of anemia is still unclear in patients with chronic heart failure (CHF). Hepcidin is an iron regulatory peptide that is synthesized in the liver to suppress iron absorption and utilization. Hepcidin synthesis is suppressed by anemia, hypoxia and erythropoiesis, and induced by inflammation. Inflammatory cytokines, such as interleukin-6 (IL-6), increase the synthesis of hepcidin, resulting in anemia of inflammation (AI). The serum hepcidin concentration in CHF patients with anemia was measured in order to better understand anemia in CHF.


RESULTS
Serum hepcidin-25, erythropoietin (EPO), ferritin and IL-6 concentrations were measured in 61 CHF patients. Among these patients, 36 patients had anemia. A group of 16 patients without cardiac disease or anemia were recruited as controls. Serum IL-6 and EPO were higher and hepcidin-25 was lower in CHF patients with anemia than in controls. Hepcidin-25 correlated with EPO and ferritin but not with IL-6. Results of multivariable regression analysis showed that independent predictors of serum hepcidin-25 included EPO and ferritin but not IL-6.


CONCLUSIONS
Serum hepcidin-25 concentrations were regulated by iron storage and erythropoiesis but not by IL-6 in CHF patients with anemia. These findings might indicate that AI is a minor cause of anemia in CHF.
Matsumoto
Mika
M
Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
Tsujino
Takeshi
T
Lee-Kawabata
Masaaki
M
Naito
Yoshiro
Y
Akahori
Hirokuni
H
Sakoda
Tsuyoshi
T
Ohyanagi
Mitsumasa
M
Tomosugi
Naohisa
N
Masuyama
Tohru
T
D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000097:blood*; D023181:Antimicrobial Cationic Peptides / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002908:Chronic Disease; D015536:Down-Regulation; D004921:Erythropoietin / Q000097:blood; D005260:Female; D005293:Ferritins / Q000097:blood; D006333:Heart Failure / Q000097:blood*; D064451:Hepcidins; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D023181:Antimicrobial Cationic Peptides; D015415:Biomarkers; D064451:Hepcidins; C508600:IL6 protein, human; D018836:Inflammation Mediators; D015850:Interleukin-6; C545475:hepcidin 25, human; D004921:Erythropoietin; D005293:Ferritins