Skip to main content

Advertisement

SpringerLink
Log in

Serum hepcidin concentrations correlate with serum iron level and outcome in patients with intracerebral hemorrhage

  • Original Article
  • Published:
Neurological Sciences Aims and scope Submit manuscript

Abstract

Iron plays a detrimental role in the intracerebral hemorrhage (ICH)-induced brain damage, while hepcidin is the most important iron-regulated hormone. Here, we investigate the association between serum hepcidin and serum iron, outcome in patients with ICH. Serum samples of 81 cases with ICH were obtained on consecutive days to detect the levels of hepcidin, iron, interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α). The National Institutes of Health Stroke Scale score (NIHSS) was measured at admission and on days 7 and 30, and the modified Rankin Scale (mRS) score was evaluated at 3 months after ICH. Additionally, the correlations of serum hepcidin with serum iron and the mRS score were analyzed by a generalized linear model. Higher serum hepcidin levels were detected in patients with poor outcomes (P < 0.001), and the mRS score increased by a mean of 1.135 points (95 % CI 1.021–1.247, P < 0.001) for every serum hepcidin quartile after adjusting for other prognostic variables. Pearson correlation analysis showed that serum hepcidin was negatively correlated with serum iron (r = −0.5301, P < 0.001), and a significantly lower concentration of serum iron was found in patients with poor outcomes (P = 0.007). Additionally, serum hepcidin was independently correlated with mRS scores of ICH patients (OR 1.115, 95 % CI 0.995–1.249, P = 0.021). Our results suggest that serum hepcidin is closely related to the outcome of patients with ICH and may be a biological marker for outcome prediction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Keep RF, Hua Y, Xi G (2012) Intracerebral haemorrhage: mechanisms of injury and therapeutic targets. Lancet Neurol 11:720–731

    Article  CAS  PubMed  Google Scholar 

  2. Xiong XY, Wang J, Qian ZM, Yang QW (2014) Iron and intracerebral hemorrhage: from mechanism to translation. Transl Stroke Res 5:429–441

    Article  CAS  PubMed  Google Scholar 

  3. Kehrer JP (2000) The Haber-Weiss reaction and mechanisms of toxicity. Toxicology 149:43–50

    Article  CAS  PubMed  Google Scholar 

  4. Gu Y, Hua Y, He Y, Wang L, Hu H, Keep RF et al (2011) Iron accumulation and DNA damage in a pig model of intracerebral hemorrhage. Acta Neurochir Suppl 111:123–128

    Article  PubMed  Google Scholar 

  5. Nakamura T, Keep RF, Hua Y, Hoff JT, Xi G (2005) Oxidative DNA injury after experimental intracerebral hemorrhage. Brain Res 1039:30–36

    Article  CAS  PubMed  Google Scholar 

  6. Gu Y, Hua Y, Keep RF, Morgenstern LB, Xi G (2009) Deferoxamine reduces intracerebral hematoma-induced iron accumulation and neuronal death in piglets. Stroke 40:2241–2243

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  7. Nakamura T, Keep RF, Hua Y, Schallert T, Hoff JT, Xi G (2004) Deferoxamine-induced attenuation of brain edema and neurological deficits in a rat model of intracerebral hemorrhage. J Neurosurg 100:672–678

    Article  CAS  PubMed  Google Scholar 

  8. Auriat AM, Silasi G, Wei Z, Paquette R, Paterson P, Nichol H et al (2012) Ferric iron chelation lowers brain iron levels after intracerebral hemorrhage in rats but does not improve outcome. Exp Neurol 234:136–143

    Article  CAS  PubMed  Google Scholar 

  9. Zhao F, Hua Y, He Y, Keep RF, Xi G (2011) Minocycline-induced attenuation of iron overload and brain injury after experimental intracerebral hemorrhage. Stroke 42:3587–3593

    Article  PubMed Central  PubMed  Google Scholar 

  10. Xi G, Strahle J, Hua Y, Keep RF (2014) Progress in translational research on intracerebral hemorrhage: is there an end in sight? Prog Neurobiol 115:45–63

    Article  PubMed  Google Scholar 

  11. Wu J, Hua Y, Keep RF, Nakamura T, Hoff JT, Xi G (2003) Iron and iron-handling proteins in the brain after intracerebral hemorrhage. Stroke 34:2964–2969

    Article  CAS  PubMed  Google Scholar 

  12. Zhao N, Zhang AS, Enns CA (2013) Iron regulation by hepcidin. J Clin Invest 123:2337–2343

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  13. Ganz T, Nemeth E (2012) Hepcidin and iron homeostasis. BBA-Mo Cell Res 1823:1434–1443

    CAS  Google Scholar 

  14. Nemeth E, Tuttle MS, Powelson J, Vaughn MB, Donovan A, Ward DM et al (2004) Hepcidin regulates cellular iron efflux by binding to ferroportin and inducing its internalization. Science 306:2090–2093

    Article  CAS  PubMed  Google Scholar 

  15. Mecklenburg I, Reznik D, Fasler-Kan E, Drewe J, Beglinger C, Hruz P (2014) Serum hepcidin concentrations correlate with ferritin in patients with inflammatory bowel disease. J Crohns Colitis 8:1392–1397

    Article  PubMed  Google Scholar 

  16. Mehdiratta M, Kumar S, Hackney D, Schlaug G, Selim M (2008) Association between serum ferritin level and perihematoma edema volume in patients with spontaneous intracerebral hemorrhage. Stroke 39:1165–1170

    Article  CAS  PubMed  Google Scholar 

  17. de la Ossa NP, Sobrino T, Silva Y, Blanco M, Millán M, Gomis M et al (2010) Iron-related brain damage in patients with intracerebral hemorrhage. Stroke 41:810–813

    Article  Google Scholar 

  18. Steiner T, Kaste M, Katse M, Forsting M, Mendelow D, Kwiecinski H et al (2005) Recommendations for the management of intracranial haemorrhage-part I: spontaneous intracerebral haemorrhage. Cerebrovasc Dis (Basel, Switz) 22:294–316

    Google Scholar 

  19. Zhou Y, Xiong KL, Lin S, Zhong Q, Lu FL, Liang H et al (2010) Elevation of high-mobility group protein box-1 in serum correlates with severity of acute intracerebral hemorrhage. Mediat Inflamm 2010:2010

    Google Scholar 

  20. Fang H, Chen J, Lin S, Wang P, Wang Y, Xiong X et al (2014) CD36-mediated hematoma absorption following intracerebral hemorrhage: negative regulation by TLR4 signaling. J Immunol 192:5984–5992

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  21. Kothari RU, Brott T, Broderick JP, Barsan WG, Sauerbeck LR, Zuccarello M et al (1996) The ABCs of measuring intracerebral hemorrhage volumes. Stroke 27:1304–1305

    Article  CAS  PubMed  Google Scholar 

  22. Urrutia P, Aguirre P, Esparza A, Tapia V, Mena NP, Arredondo M et al (2013) Inflammation alters the expression of DMT1, FPN1 and hepcidin, and it causes iron accumulation in central nervous system cells. J Neurochem 126:541–549

    Article  CAS  PubMed  Google Scholar 

  23. Thomas C, Kobold U, Balan S, Roeddiger R, Thomas L (2011) Serum hepcidin-25 may replace the ferritin index in the Thomas plot in assessing iron status in anemic patients. Int J Lab Hematol 33:187–193

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by grants from the National Natural Science Foundation of China (81271283, 81471191) and the National Basic Research Program of China (973 Program) (2014CB541605).

Conflict of interest

The authors declare no conflict of interest.

Author information

Author notes

    Authors and Affiliations

    1. Department of Neurology, Xinqiao Hospital, Third Military Medical University, No. 183, Xinqiao Main Street, Shapingba District, Chongqing, 400037, China

      Xiao-Yi Xiong, Jing Chen, Wen-Yao Zhu, Ting Zhao, Qi Zhong, Kai Zhou, Zhao-You Meng, Yan-Chun Wang, Peng-Fei Wang, Huang Fang & Qing-Wu Yang

    Authors
    1. Xiao-Yi Xiong
      View author publications

      You can also search for this author in PubMed Google Scholar

    2. Jing Chen
      View author publications

      You can also search for this author in PubMed Google Scholar

    3. Wen-Yao Zhu
      View author publications

      You can also search for this author in PubMed Google Scholar

    4. Ting Zhao
      View author publications

      You can also search for this author in PubMed Google Scholar

    5. Qi Zhong
      View author publications

      You can also search for this author in PubMed Google Scholar

    6. Kai Zhou
      View author publications

      You can also search for this author in PubMed Google Scholar

    7. Zhao-You Meng
      View author publications

      You can also search for this author in PubMed Google Scholar

    8. Yan-Chun Wang
      View author publications

      You can also search for this author in PubMed Google Scholar

    9. Peng-Fei Wang
      View author publications

      You can also search for this author in PubMed Google Scholar

    10. Huang Fang
      View author publications

      You can also search for this author in PubMed Google Scholar

    11. Qing-Wu Yang
      View author publications

      You can also search for this author in PubMed Google Scholar

    Corresponding author

    Correspondence to Qing-Wu Yang.

    Additional information

    X.-Y. Xiong and J. Chen contributed equally to this work.

    Rights and permissions

    Reprints and permissions

    About this article

    Check for updates. Verify currency and authenticity via CrossMark

    Cite this article

    Xiong, XY., Chen, J., Zhu, WY. et al. Serum hepcidin concentrations correlate with serum iron level and outcome in patients with intracerebral hemorrhage. Neurol Sci 36, 1843–1849 (2015). https://doi.org/10.1007/s10072-015-2266-2

    Download citation

    • Received:

    • Accepted:

    • Published:

    • Issue Date:

    • DOI: https://doi.org/10.1007/s10072-015-2266-2

    Keywords

    Search

    Navigation