Hepcidin and serum iron: a correlational study in obstetric patients with iron deficiency anaemia in windhoek, namibia, in 2017

Background: Anaemia is a worldwide major health concern. It is especially important in pregnant women due to the increased requirements for both the mother and the baby. Horowitz et al., (2013) states that Iron deficiency anaemia accounts for 75% of all anaemias in pregnancy.
Aim and Objectives: The interest of this study was to correlate serum iron levels to hepcidin, the iron regulatory peptide. The study objectives were to evaluate the quantitative behavior of hepcidin in obstetric patients with IDA and to observe the relationship between haemoglobin, serum iron and hepcidin levels in pregnant women.
Methodology: Two hundred and eighty-three samples of pregnant women from the ANC ward were collected from NIP between June and September 2017. These samples were required to have an Hb of less than 12g/dL. The samples were tested for iron to determine those with iron deficiency anaemia. Finally, samples with iron deficiency were tested for hepcidin levels. Additional samples were included to complete the hepcidin assay.
Results: 107 samples had an iron concentration of less than 7.16µmol/L and were classified as iron deficient. Hepcidin analysis was then carried out on 176 samples (including the 108 with iron deficiency and some normal and high (higher than 26.85µmol/L) to observe if a direct proportionality exists in high iron concentrations. The results indicated a poor, but significant correlation between haemoglobin and serum iron (r=0.163, p=0.032). According to the r value, there is a weak positive linear relationship between haemoglobin and serum iron. Furthermore, haemoglobin and hepcidin showed a weak uphill (positive) linear correlation (r=0.123, P=0.106).
Conclusion: The study found that hepcidin had a weaker correlation to haemoglobin than serum iron to haemoglobin. Hb is a poor indicator of IDA because of haemodynamic changes and the slow rate of iron being incorporated and raising Hb. Additionally, the weak relationship between haemoglobin and hepcidin is a result of erythropoeitc drive and hepcidin sensitivity, because while increased serum iron increases hepcidin, erythropoietic drive lowers it. Inflammation, which is common in pregnancy also raises hepcidin, altering the normal homeostatic mechanism of iron. These factors have thereby influenced the degree of their direct proportionality. Therefore, serum iron is the better diagnostic tool for IDA.