The Change Of Hepcidin In Pregnant Women With Iron Deficiency Anemia

Objective: Iron is one of the essential trace elements in the body. Theneeds for iron increasing during pregnancy, so the iron deficiency is acommon phenomenon in pregnant women and is one of the most commoncauses in pregnancy anemia. Thus it is crucial for maintaining homeostasis ofiron metabolism in pregnancy. Hepcidin has been identified as a keyregulatory hormone in iron balance. Hepcidin synthesis mainly occuerd inliver cells and is secreted into the bloodstream, then eventually excreted by thekidneys. It has been indicated that hepcidin plays important role onpathogenesis of iron deficiency anemia, chronic disease anemia, hereditaryhemochromatosis and other iron metabolism disorder disease. Synthesis ofhepcidin by liver was decreased and intestinal iron absorption increasedduring anemia. So the researchers think it is a negative regulator of ironabsorption from the intestine and released from macrophages. But the presentstudy is less about expression and regulatory role of hepcidin for pregnantwomen with iron deficiency anemia. This study is to explore the correlationbetween hepcidin and red blood cell parameters, iron parameters,erythropoietin(EPO) and the inflammatory markers C-reactive protein byobserving the hepcidin expression level in different degree of iron deficiencyanemia and further clarify the regulatory role of hepcidin in pregnant womenwith iron deficiency anemia.Methods: The experiments were divided into four groups: healthycontrol group(Control, as the healthy non pregnant women), normal pregnantwomen group(Normal), pregnant women with mild anemia group(Mildanemia), pregnant women with moderate anemia group(Moderate anemia).Each group include 20 cases, all blood samples were collected after 8 h offasting. Two ml blood was mixed thoroughly with EDTA-K2 anticoagulant invacuum tube. The ratio of blood and anticoagulant agents is 1:9. At the sametime Serum was obtained by centrifuge 5 minutes with 3ml blood(3000g /min). Blood routine was detected by automatic blood cell analyzer LH750.Hepcidin-25, erythropoietin(EPO), serum ferritin(SF) and serum transferrin(TRF) were detected by ELISA method. Serum iron(SI) and total iron bindingcapacity(TIBC) by the spectrophotometric colorimetric method and C-reactive protein(CRP) by immune turbidity method. The data comparison wasanalysed between two groups. The data was analysed in all pregnant women(include normal pregnant women, mild anemia pregnant women and moderateanemia pregnant women)to explore the correlation between hepcidin and redblood cell parameters, iron parameters, EPO and CRP during pregnancy.SPSS13.0 software was used in this study.Results: 1 Compared with control group, serum iron and serum ferritindecreased gradually in normal group, mild anemia group and moderate anemiagroups, but the serum iron decreased more significantly(P<0.05), serumferritin decreased without significance. Transferrin increased gradually fromnormal group, mild anemia group and moderate anemia group, but nostatistical significance(P>0.05). Transferrin was more lower in moderateanemia group than in control group(P<0.05). Compared with control groupand normal group respectively, total iron binding capacity was increasedsignificantly in mild anemia group and moderate anemia group(P<0.05).Total iron binding capacity was more higher in moderate anemia group than inmild anemia group(P<0.05).2 Erythropoietin in moderate anemia group were more higher than thoseof control groupt, normal group and anemia group(P<0.05). There was nosignificant difference among these three groups(P>0.05).3 Compared with control group, hepcodin level was significantlydecreased in normal group, mild anemia group and moderate anemia group(P<0.05), Compared with normal group, hepcidin level was decreasedsignificantly in mild anemia group and moderate anemia group(P<0.05),There was no significant difference between mild anemia group and moderateanemia group(P>0.05).4 Compared with control group, C- reaction protein was increasedsignificantly in normal group, mild anemia group and moderate anemia group(P<0.05). CRP in moderate anemia group was more higher than in normalgroup(P <0.05).5 There were positive correlation between hepcidin and HGB, HCT,MCV, MCH, MCHC, SI. Correlation coefficients respectively were HGB(r=0.755, P<0.001), HCT(r=0.758, P<0.001), MCV(r=0.604, P<0.001),MCH(r=0.683, P<0.001), MCHC(r=0.480, P<0.001) and SI(r=0.716, P<0.001).The negative correlation coefficients of hepcidin with TIBC and EPOrespectively were TIBC(r=-0.664, P<0.001) and EPO( r=-0.404, P<0.001).There were no significant correlation between hepcidin and SF, TRF, CRP.Correlation coefficients respectively were SF( r=0.267, P=0.088), TRF(r=-0.216, P=0.135)and CRP(r=-0.193, P=0.183).Conclusions: There were positive correlation between hepcidin levelsand red blood cell parameters, serum iron during pregnancy, negativecorrelated with total iron binding capacity and EPO. There were no significantcorrelation between hepcidin and inflammatory markers. The downregulationof hepcidin in pregnant women with iron deficiency anemia may be relatedwith the regulation of EPO.