Hepcidin Status among Iron Deficient Anemic Pregnant Women in Gaza strip: A Case Control Study

Abstract

Background: Hepcidin, a peptide hormone composed of 25 amino acids. Hepcidin is synthesized mainly in the liver. Iron deficiency anemia (IDA) is common during pregnancy and is associated with higher maternal morbidity and mortality in Gaza strip. Understanding of hepcidin hormone and its role in iron metabolism could lead to new indicators for earlier detection of cases with IDA. Objective: To assess hepcidin status among IDA pregnant women and its relationship with some biochemical variables in Gaza strip. Materials and methods: A case control study this study comprised 45 IDA pregnant women and 45 healthy pregnant women. Questionnaire interviews were applied among the study population. Serum hepcidin and ferritin were measured by ELISA, iron and TIBC were determined photometrically. Complete blood count (CBC) was also performed. Transferrin and transferrin saturation were calculated. An approval was obtained from local ethical committee to conduct this study. Overall data were computer analyzed using SPSS. Results: The mean level of serum hepcidin, iron, transferrin saturation, and ferritin in cases were significantly lower than that in controls (2.6±4 ng/ml, 63.2±25.3 µg/dl, 15.6±8.0% and 8.0±9.7 ng/ml versus 7.5±7.3 ng/ml, 77.7±22.9 µg/dl, 23.5±8.0% and 15.4±14.3 ng/ml respectively with p=0.000). The Pearson correlation test showed positive significant correlations between hepcidin levels and serum iron, ferritin, and transferrin saturation (r=0.547, p=0.000; r=0.558, p=0.000 & r=0.577, p=0.000 respectively). On the other hand, negative correlations were showed with TIBC and transferrin (r=-0.551, p=0.000 & r=-0.526, p=0.000) respectively. The average values of RBC, Hb, HCT, MCV, MCH, and MCHC were significantly lower among IDA pregnant women (3.3±2.4, 9.7±0.8, 29.4±2.3, 76.6±4.8, 25.6±2.2 & 33.2±1.5 respectively) compared to controls (4.0±0.3, 11.8±0.6, 34.7±2.0, 86.3±3.3, 29.4±1.3 & 34±0.9; p=0.000) respectively. RDW was significantly higher in cases vs. controls (16.6±2.4, 13.7±0.6; p=0.000). Conclusions: Hepcidin hormone was lower in IDA pregnant women than healthy pregnant women. Thus it is recommended to carry out further studies to evaluate the role of hepcidin in the diagnosis of IDA among different gestational women.