Alpha 1-acid glycoprotein, hepcidin, C-reactive protein, and serum ferritin are correlated in anemic schoolchildren with Schistosoma haematobium.
BACKGROUND
The World Health Organization and Centers for Disease Control and Prevention recommend the inclusion of indicators of iron status and inflammation in surveys assessing iron deficiency and/or anemia.


OBJECTIVE
We examined the associations between serum alpha(1)-acid glycoprotein (AGP), serum C-reactive protein (CRP), and urinary hepcidin and their relations with serum ferritin (SF), serum transferrin receptor (sTfR), and hemoglobin.


METHODS
At enrollment, the measurements were made in randomly selected 7-12-y-old anemic children with documented Schistosoma haematobium infection (n = 224 for AGP, CRP, SF, sTfR, and hemoglobin; n = 61 for urinary hepcidin).


RESULTS
The correlation between the conventional markers of inflammation, AGP and CRP, was positive (r = 0.40, P < 0.01), and the correlation between the unambiguous markers of iron nutrition, hemoglobin and s-TfR, was negative (r = -0.36, P < 0.01). None of the correlations (r < 0.08) between the above markers was statistically significant. Urinary hepcidin correlated positively with the 2 measured indicators of inflammation (r > or = 0.42, P < 0.01) but not with the 2 indicators of iron nutrition (r < 0.07). SF correlated positively with the 2 measured inflammation markers (r > or = 0.25, P < 0.01) and the 2 iron-nutrition indicators (r > 0.26, P < 0.01). Urinary hepcidin correlated positively with SF (r = 0.39, P < 0.01). Regression analyses suggested that CRP and AGP were significant predictors of SF (P < 0.001); however, CRP (R(2) = 0.38) explained more of SF's variance than did AGP (R(2) = 0.17).


CONCLUSIONS
Correlations between AGP, CRP, urinary hepcidin, and SF were statistically significant. CRP values explained SF's variance better than did the other markers of inflammation studied. We therefore recommend the measurement of both AGP and CRP in population surveys that include an assessment of iron deficiency in developing countries.
Ayoya
Mohamed A
MA
Cornell University, Ithaca, NY, USA. mayoya@unicef.org <mayoya@unicef.org>
Spiekermann-Brouwer
Gerburg M
GM
Stoltzfus
Rebecca J
RJ
Nemeth
Elizabeta
E
Habicht
Jean-Pierre
JP
Ganz
Tomas
T
Rawat
Rahul
R
Traoré
Abdel K
AK
Garza
Cutberto
C
D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000469:parasitology*; D000818:Animals; D023181:Antimicrobial Cationic Peptides / Q000097:blood* / Q000652:urine; D002097:C-Reactive Protein / Q000378:metabolism*; D002648:Child; D005293:Ferritins / Q000097:blood*; D006454:Hemoglobins / Q000378:metabolism; D064451:Hepcidins; D006801:Humans; D008302:Mali; D009961:Orosomucoid / Q000378:metabolism*; D018512:Parasitemia / Q000097:blood / Q000469:parasitology; D011990:Receptors, Transferrin / Q000097:blood; D012548:Schistosoma haematobium; D012553:Schistosomiasis haematobia / Q000097:blood* / Q000469:parasitology; D014505:Urban Population
D023181:Antimicrobial Cationic Peptides; C578702:HAMP protein, human; D006454:Hemoglobins; D064451:Hepcidins; D009961:Orosomucoid; D011990:Receptors, Transferrin; D002097:C-Reactive Protein; D005293:Ferritins