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Serum hepcidin levels in Helicobacter pylori-infected children with iron-deficiency anemia: a case–control study

Annals of Hematology volume 92, pages 1477–1483 (2013)Cite this article

Abstract

Recently, hepcidin, an antimicrobial-like peptide hormone, has evolved as the master regulator of systemic iron homeostasis. Hepcidin integrates signals from diverse physiological inputs, forming a key connection between iron trafficking and response to infection. In this study, we aimed to investigate whether Helicobacter pylori infection modulates serum hepcidin level and response to oral iron therapy in children with iron-deficiency anemia. This was a case–control study including 60 children with iron-deficiency anemia (IDA; 30 H. pylori infected and 30 H. pylori noninfected) and 30 healthy children with comparable age and gender as the control group. Iron parameters including serum iron, ferritin, transferrin, total iron binding capacity, and transferrin saturation and serum hepcidin levels were assessed initially and after 3 months of oral iron therapy for IDA. Compared to the control group, serum hepcidin was significantly lower in H. pylori-noninfected children with IDA (P < 0.01) and significantly higher in H. pylori-infected children with IDA (P < 0.01). Hepcidin increased significantly in noninfected children with IDA after 3 months of oral iron therapy (P < 0.01). On the other hand, H. pylori-infected children showed nonsignificant change in hepcidin level after oral iron therapy (P > 0.05). Although hepcidin showed significant positive correlations with serum ferritin, hemoglobin (Hb), iron, and transferrin saturation in noninfected children with IDA (P < 0.01), it showed significant negative correlations with serum ferritin, Hb, iron, and transferrin saturation in H. pylori-infected children with IDA (P < 0.05). H. pylori infection upregulates serum hepcidin levels and was associated with diminished response to oral iron therapy in children with iron-deficiency anemia.

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Acknowledgments

The authors would like to thank Dr. Mona Abo Serea for her statistical assistance. The authors also thank the staff of outpatient clinics in Zagazig University Children’s Hospital for their collaboration in sampling as well as our patients who participated in the study. Our institutional review committee of ethical research approved the study.

Conflict of interest

The authors declare that they have no conflict of interest.

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Affiliations

  1. Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt

    Seham F. A. Azab

  2. Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt

    Asmaa M. H. Esh

  3. 18 Omar Bin Elkhattab St, Al Qawmia, Zagazig, Sharkia Governorate, Egypt

    Seham F. A. Azab

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  1. Seham F. A. Azab
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  2. Asmaa M. H. Esh
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Correspondence to Seham F. A. Azab.

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Azab, S.F.A., Esh, A.M.H. Serum hepcidin levels in Helicobacter pylori-infected children with iron-deficiency anemia: a case–control study. Ann Hematol 92, 1477–1483 (2013). https://doi.org/10.1007/s00277-013-1813-2

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  • DOI: https://doi.org/10.1007/s00277-013-1813-2

Keywords

  • Hepcidin
  • Iron deficiency
  • Anemia
  • Helicobacter pylori
  • Children