title: Serum hepcidin and prohepcidin concentrations in inflammatory bowel disease.
abstract: BACKGROUND
  Anemia is an important complication of inflammatory bowel disease (IBD). Recent data suggest that hepcidin is a major mediator of anemia with a central role in iron homeostasis and metabolism. The aim of this study was to evaluate the serum levels of hepcidin and its prohormone, prohepcidin, in patients with IBD in comparison with healthy controls.
  
  
  METHODS
  One hundred patients with IBD [49 ulcerative colitis (UC), 51 Crohn's disease (CD)] and 102 healthy controls were enrolled. Serum hepcidin and prohepcidin levels were measured by commercially available enzyme-linked immunosorbent assays kits. Their relationship with clinical and laboratory parameters of UC and CD was assessed.
  
  
  RESULTS
  Median hepcidin levels were significantly higher in both patients with UC and patients with CD compared with healthy controls (P<0.0001). Median prohepcidin levels were significantly lower in patients with IBD compared with healthy controls (P = 0.03). In the univariate analysis, serum hepcidin was significantly negatively correlated (r = -0.36, P = 0.0003), whereas serum prohepcidin was positively correlated (r = 0.65, P<0.0001) with the hemoglobin levels. Significant correlations of both hepcidin (r = 0.34, P = 0.0007) and prohepcidin (r = -0.21, P = 0.04) with ferritin levels were found in patients with IBD. Serum hepcidin was also correlated with disease activity (for UC, r = 0.36, P = 0.009) and C-reactive protein (r = 0.29, P = 0.004). After multivariate analysis serum hepcidin levels remained significantly correlated with ferritin (P = 0.0008) and disease activity (for UC, P = 0.004).
  
  
  CONCLUSIONS
  Serum hepcidin and prohepcidin levels are significantly altered in patients with IBD compared with healthy controls. This finding suggests a substantial role of these two hormones in the development of anemia in IBD.
authors.affiliation: Department of Gastroenterology, University Hospital Heraklion, Crete, Greece.
authors.forename: Pantelis
authors.initials: P
authors.lastname: Oustamanolakis
authors.forename: Ioannis E
authors.initials: IE
authors.lastname: Koutroubakis
authors.forename: Ippokratis
authors.initials: I
authors.lastname: Messaritakis
authors.forename: Niki
authors.initials: N
authors.lastname: Malliaraki
authors.forename: Aekaterini
authors.initials: A
authors.lastname: Sfiridaki
authors.forename: Elias A
authors.initials: EA
authors.lastname: Kouroumalis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000740:Anemia / Q000209:etiology; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D023181:Antimicrobial Cationic Peptides / Q000097:blood*; D001379:Azathioprine / Q000627:therapeutic use; D002097:C-Reactive Protein / Q000378:metabolism; D003430:Cross-Sectional Studies; D004338:Drug Combinations; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D005944:Glucosamine / Q000031:analogs & derivatives / Q000627:therapeutic use; D064451:Hepcidins; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D007501:Iron / Q000097:blood / Q000378:metabolism; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D011498:Protein Precursors / Q000097:blood*; D012907:Smoking / Q000009:adverse effects; D012460:Sulfasalazine / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D023181:Antimicrobial Cationic Peptides; D004338:Drug Combinations; D004791:Enzyme Inhibitors; D005765:Gastrointestinal Agents; C578702:HAMP protein, human; D064451:Hepcidins; D011498:Protein Precursors; C028423:Salazopyrine; D012460:Sulfasalazine; D002097:C-Reactive Protein; D007501:Iron; D001379:Azathioprine; D005944:Glucosamine; D008727:Methotrexate