Plasma Concentrations of Hepcidin in Anemic Zimbabwean Infants.

Autor: Mupfudze TG; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America; Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe., Stoltzfus RJ; Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States of America., Rukobo S; Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe., Moulton LH; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America., Humphrey JH; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America; Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe., Prendergast AJ; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America; Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe; Blizard Institute, Queen Mary University of London, London, United Kingdom., Jones AD, Manges A, Mangwadu G, Maluccio JA, Mbuya MN, Ntozini R, Tielsch JM
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2015 Aug 07; Vol. 10 (8), pp. e0135227. Date of Electronic Publication: 2015 Aug 07 (Print Publication: 2015).
DOI: 10.1371/journal.pone.0135227
Abstrakt: Objective: Anemia in infancy is a global public health problem. We evaluated the relative contributions of iron deficiency and inflammation to infant anemia.
Methods: We measured plasma hepcidin, ferritin, soluble transferrin receptor (sTfR), alpha-1-acid glycoprotein and C-reactive protein (CRP) by ELISA on archived plasma from 289 HIV-unexposed anemic or non-anemic Zimbabwean infants at ages 3 mo, 6 mo and 12 mo. Among anemic infants, we determined the proportion with iron-deficiency anemia (IDA) and anemia of inflammation (AI). We undertook regression analyses of plasma hepcidin and anemia status, adjusting for sex, age and birthweight.
Results: Anemic infants at 3 mo were more stunted and had higher CRP (median 0.45 vs 0.21 mg/L; P = 0.037) and hepcidin (median 14.7 vs 9.7 ng/mL; P = 0.022) than non-anemic infants, but similar levels of ferritin and sTfR; 11% infants had IDA and 15% had AI. Anemic infants at 6 mo had higher hepcidin (median 7.9 vs 4.5 ng/mL; P = 0.016) and CRP (median 2.33 vs 0.32 mg/L; P<0.001), but lower ferritin (median 13.2 vs 25.1 μg/L; P<0.001) than non-anemic infants; 56% infants had IDA and 12% had AI. Anemic infants at 12 mo had lower ferritin (median 3.2 vs 22.2 μg/L; P<0.001) and hepcidin (median 0.9 vs 1.9 ng/mL; P = 0.019), but similar CRP levels; 48% infants had IDA and 8% had AI. Comparing anemic with non-anemic infants, plasma hepcidin was 568% higher, 405% higher and 64% lower at 3 mo, 6 mo and 12 mo, respectively, after adjusting for sex and birthweight (all p<0.01). Plasma hepcidin declined significantly with age among anemic but not non-anemic infants. Girls had 61% higher hepcidin than boys, after adjusting for age, anemia and birthweight (p<0.001).
Conclusion: Anemia is driven partly by inflammation early in infancy, and by iron deficiency later in infancy, with plasma hepcidin concentrations reflecting the relative contribution of each. However, there is need to better characterize the drivers of hepcidin during infancy in developing countries.
Databáze: MEDLINE
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