title: Hepcidin and hemoglobin content parameters in the diagnosis of iron deficiency in rheumatoid arthritis patients with anemia.
abstract: OBJECTIVE
  To explore the utility of the novel iron indices hepcidin, reticulocyte hemoglobin content (Ret-Hgb), and erythrocyte (red blood cell) hemoglobin content (RBC-Hgb) for detection of iron deficiency in rheumatoid arthritis (RA) patients with anemia and active inflammation and to compare these indices with conventional parameters of iron deficiency.
  
  
  METHODS
  Blood samples from 106 outpatients with RA were analyzed in a cross-sectional exploratory study. Forty patients were classified as having either iron deficiency anemia (IDA), anemia of chronic disease (ACD), their combination (IDA/ACD), or "other anemia" based on biochemical parameters for inflammation and iron deficiency. The ability of serum and urine hepcidin, Ret-Hgb, and RBC-Hgb measurement to discriminate among these states was evaluated.
  
  
  RESULTS
  Hepcidin content in serum from patients in the IDA group as well as that from patients in the combined IDA/ACD group differed significantly from that in serum from patients in the ACD group. This difference was also observed with hepcidin in urine, Ret-Hgb, and RBC-Hgb, although with less significance. The area under the receiver operating characteristic curve for serum hepcidin was 0.88 for the comparison of IDA/ACD patients with ACD patients and 0.92 for the comparison of the combined IDA group and IDA/ACD group to all other patients with anemia. Hepcidin at <2.4 nmoles/liter had a sensitivity of 89% and a specificity of 88% to distinguish IDA/ACD from ACD. Both Ret-Hgb and RBC-Hgb measurements also allowed differentiation between these latter groups, with a sensitivity of 67% and 89%, respectively, and a specificity of 100% and 75%, respectively.
  
  
  CONCLUSIONS
  Serum hepcidin and, to a lesser extent, urine hepcidin, Ret-Hgb, and RBC-Hgb, are potential useful indicators for detecting iron deficiency in RA patients with anemia and active inflammation.
authors: Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors: Susanne
authors: S
authors: van Santen
authors: Edmée C
authors: EC
authors: van Dongen-Lases
authors: Femmie
authors: F
authors: de Vegt
authors: Coby M M
authors: CM
authors: Laarakkers
authors: Piet L C M
authors: PL
authors: van Riel
authors: Annelies E
authors: AE
authors: van Ede
authors: Dorine W
authors: DW
authors: Swinkels
mesh_terms: D000328:Adult; D000368:Aged; D018798:Anemia, Iron-Deficiency / Q000175:diagnosis* / Q000453:epidemiology* / Q000378:metabolism; D023181:Antimicrobial Cationic Peptides / Q000097:blood* / Q000652:urine; D001172:Arthritis, Rheumatoid / Q000453:epidemiology*; D015415:Biomarkers / Q000378:metabolism; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006454:Hemoglobins / Q000378:metabolism*; D064451:Hepcidins; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D023181:Antimicrobial Cationic Peptides; D015415:Biomarkers; C578702:HAMP protein, human; D006454:Hemoglobins; D064451:Hepcidins