title: Effects of iron supplementation on serum hepcidin and serum erythropoietin in low-birth-weight infants.
abstract: BACKGROUND
  The iron-regulatory hormone hepcidin has not been studied in infants, who experience large physiologic changes in iron status.
  
  
  OBJECTIVE
  The objective was to study hepcidin and erythropoietin and their correlation with iron status in iron-replete and iron-deficient low-birth-weight (LBW) infants-a group at particular risk of iron deficiency (ID).
  
  
  METHODS
  We randomly assigned 285 otherwise healthy LBW infants to receive, from 6 wk to 6 mo of age, 3 doses of iron supplements: 0 (placebo), 1, or 2 mg/kg daily. Hepcidin, erythropoietin, hemoglobin, and variables of iron status were analyzed.
  
  
  RESULTS
  Serum hepcidin did not change over time in the placebo group, despite a rapid decrease in serum ferritin. In iron-supplemented infants, hepcidin increased significantly, reaching a mean (±SD) concentration of 19.2 ± 2.5 ng/mL in the 2-mg/kg group compared with 13.0 ± 2.6 ng/mL in the placebo group at age 6 mo (P < 0.001). The difference was even larger between iron-deficient and iron-replete infants. Hepcidin was independently positively correlated with ferritin at all ages and was negatively correlated with the transferrin receptor concentration at age 6 wk and with transferrin at age 6 mo. Erythropoietin was initially similar between groups but decreased significantly in iron-supplemented infants. In addition to being negatively correlated with hemoglobin, it was also independently negatively correlated with indicators of iron status.
  
  
  CONCLUSIONS
  Hepcidin is closely associated with iron status and may be a useful indicator of iron stores and ID in infants. Erythropoietin is negatively correlated with iron status, which suggests a feedback mechanism that needs further study. This trial is registered at clinicaltrials.gov as NCT00558454.
authors.affiliation: Department of Clinical Sciences, Pediatrics, Umeå University, Sweden. staffan.berglund@pediatri.umu.se
authors.forename: Staffan
authors.initials: S
authors.lastname: Berglund
authors.forename: Bo
authors.initials: B
authors.lastname: Lönnerdal
authors.forename: Björn
authors.initials: B
authors.lastname: Westrup
authors.forename: Magnus
authors.initials: M
authors.lastname: Domellöf
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000097:blood* / Q000188:drug therapy; D023181:Antimicrobial Cationic Peptides / Q000097:blood*; D019587:Dietary Supplements; D004921:Erythropoietin / Q000097:blood*; D005260:Female; D005293:Ferritins / Q000097:blood; D006454:Hemoglobins / Q000378:metabolism; D064451:Hepcidins; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight / Q000097:blood*; D007231:Infant, Newborn; D007501:Iron / Q000494:pharmacology* / Q000627:therapeutic use; D000090463:Iron Deficiencies; D008297:Male; D009752:Nutritional Status; D011990:Receptors, Transferrin / Q000097:blood; D012016:Reference Values; D014131:Trace Elements / Q000172:deficiency / Q000494:pharmacology / Q000627:therapeutic use; D014168:Transferrin / Q000378:metabolism
chemical_list: D023181:Antimicrobial Cationic Peptides; C578702:HAMP protein, human; D006454:Hemoglobins; D064451:Hepcidins; D011990:Receptors, Transferrin; D014131:Trace Elements; D014168:Transferrin; D004921:Erythropoietin; D005293:Ferritins; D007501:Iron