Correlation Of Serum Hepcidin Levels And Systemic Iron Metabolism Alteration With Disease Progression In HBV-related Diseases

Objective: According to the clinical diagnosis criteria of HBV-relatedliver diseases and disease progression, we divided the subjects into threegroups: chronic hepatitis B (CHB), hepatitis B virus (HBV)-relatedcirrhosis and HBV-related cirrhosis with hepatocellular carcinoma. Theaim of this study was to assess the serum concentrations of hepcidin inthe groups and healthy controls and measure their various critical clinicalindictors；we explore the features of the indictors in the three diseasegroups and the underlying relationship with biochemical and iron indicesto find the possible regular pattern and internal relationship.Methods: Using a recently validated matrix-assistant laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF-MS) method,we measured serum hepcidin levels of46HBV-related patients and20healthy controls with normal iron status. And the clinical indictors of ironmetabolism, liver function and infection were measured. Correlationanalysis of iron and liver function indices and clinical data and serumhepcidin levels was implemented.Results: The mean serum hepcidin level is significantly lower in healthycontrols than chronic hepatitis B (CHB); The mean serum hepcidin level is significantly lower in the patients with HBV-related cirrhosis than inthe patients of CHB and HBV-related cirrhosis with hepatocellularcarcinoma (HCC)(mean±SD:4.9±1.9ng/mL；9.8±5.0ng/mL；9.3±4.9ng/mL, respectively), and there are significant difference betweenHBV-related cirrhosis and chronic hepatitis B and HBV-related cirrhosiswith hepatocellular carcinoma (p<0.05); A lower level of hepcidin wasfound in cirrhosis group than CHB and HCC groups (28.3±4.7g/L;37.3±4.9g/L;32.3±4.8g/L) and Child–Pugh class C patients had aslightly lower value. Significant correlation was observed between serumhepcidin levels of HBV-related patients and their ferritin levels (r=0.41, p＜0.05), and HBV-DNAloading (r=0.601, p＜0.05).Conclusions: Serum hepcidin is highly stimulated in the setting ofhepatocellular carcinoma patients. And hepcidin regulation by ironburden is still maintained in HBV-related patients. It may becomeindicator of liver function with further development an validation.Furthermore, hepcidin may suppress the viral replication in the setting ofHBV-related patients.