title: Surgical inflammation induces hepcidin production after abdominal surgery.
abstract: BACKGROUND
  Hepcidin, a key regulator of iron homeostasis, is also a marker of acute inflammation. In the present study we investigated the changes in the serum hepcidin level and correlations between hepcidin and other markers of acute inflammation during the perioperative period in patients after abdominal surgery.
  
  
  METHODS
  Serum hepcidin, hemoglobin (Hb), hematocrit (Ht), white blood cell (WBC) count, frequency of neutrophils, and C-reactive protein (CRP) were measured preoperatively (Pre), and on postoperative days (POD) 1, 3, 7, and 14.
  
  
  RESULTS
  In patients undergoing gastrectomy, the median levels of hepcidin preoperatively and on POD 1, 3, 7, and 14 were 6.5, 53.1, 31.7, 15.6, and 4.0 ng/dl, respectively (p < 0.0001). The corresponding levels in colectomy patients were 8.5, 78.3, 60.1, 49.7, and 8.4 ng/dl, respectively (p = 0.0002); those in hepatectomy patients were 6.6, 16.3, 3.5, 13.4, and 3.4 ng/dl, respectively (p = 0.0022); and those in patients undergoing surgery for diffuse peritonitis were 24.8, 50.1, 43.1, 31.2, and 31.7 ng/dl, respectively (p = 0.4933). There were no significant decreases in Hb and Ht in the patients undergoing gastrectomy, colectomy, or surgery for diffuse peritonitis. The level of hepcidin was significantly correlated with the WBC count, frequency of neutrophils, and CRP level during the perioperative period for all four types of operation.
  
  
  CONCLUSIONS
  Like other inflammatory markers, an increase in the level of hepcidin (i.e., a hepcidin storm) occurs in the acute phase after gastrectomy, colectomy, hepatectomy, and surgery for diffuse peritonitis.
authors.affiliation: Second Department of Surgery, Dokkyo University School of Medicine, Kitakobayashi 880, Mibu, Shimotsuga, Tochigi, 321-0293, Japan.
authors.forename: Kyung Hwa
authors.initials: KH
authors.lastname: Park
authors.forename: Tokihiko
authors.initials: T
authors.lastname: Sawada
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kosuge
authors.forename: Junji
authors.initials: J
authors.lastname: Kita
authors.forename: Mitsugi
authors.initials: M
authors.lastname: Shimoda
authors.forename: Naohisa
authors.initials: N
authors.lastname: Tomosugi
authors.forename: Keiichi
authors.initials: K
authors.lastname: Kubota
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D023181:Antimicrobial Cationic Peptides / Q000096:biosynthesis* / Q000097:blood; D015415:Biomarkers / Q000097:blood / Q000378:metabolism; D013505:Digestive System Surgical Procedures; D005260:Female; D064451:Hepcidins; D006801:Humans; D007249:Inflammation / Q000276:immunology*; D008297:Male; D010538:Peritonitis / Q000601:surgery*
chemical_list: D023181:Antimicrobial Cationic Peptides; D015415:Biomarkers; C578702:HAMP protein, human; D064451:Hepcidins