Quantification of serum hepcidin as a potential biomarker in diagnosis of iron deficiency anaemia

Sonal Vyas, Anil Kapoor, S. K. Nema, Sanjeev Suman


Background: Iron deficiency (ID) is the most prevalent nutritional deficiency and the most common cause of anemia in the world. Present study aims to detect the serum hepcidin and ferritin levels in iron deficiency induced anaemia’s and compare and correlate the values of serum hepcidin levels with their Serum ferritin levels and IL-6 levels.

Methods: A total of 94 individuals were enrolled in the study. Sample for hematological evaluations were collected and estimation was carried out for biomarker estimation by ELISA method(s) using specified kit(s) procured commercially. The statistical evaluation was done using SPSS version 24.0. Analysis of variance (ANOVA) and Pearson's correlation tests were used to compare the variables and to see the correlation between the different variables.

Results: Serum Hepcidin, a marker of iron deficiency anemia is significantly low in patients with IDA (33.23±12.46 ng/mL) than in normal with p-value <0.001 which is highly significant. In present study, we determined the cut off points differentiating IDA from healthy group which was ≤ 34.55; with AUC 0.845 (P<0.0001), 95% confidence interval was 0.755 to 0.911, and sensitivity was 98.33 % and specificity 52.94%. These cut off points had strong confidence interval and valuable predictive potential.

Conclusions: Serum Hepcidin can be used as a simple and cost effective diagnostic marker for identification of anemia.


Anemia of chronic disease, Iron deficiency anemia, Serum hepcidin, Serum ferritin, IL-6

Full Text:



Anderson GJ, Darshan D, Wilkins SJ, Frazer DM. Regulation of Systemic Iron Homeostasis: How the Body Responds to Changes in Iron Demand. Biometals. 2007;20(3-4):665-74.

Muñoz M, Villar I, García-Erce JA. An Update on Iron Physiology. World J Gastroenterol. 2009;15(37):4617-26.

Hodges Vm, Rainey S, LappinTr, Maxwell Ap. Pathophysiology of Anemia and Erythrocytosis. Crit Rev Oncol Haematol. 2007;64(2):139-58.

Joyce JK, Dorlene VT, Jack FMW, Lambertus LM, Kiemeney FCS, Martin DH, et al. Serum Hepcidin: Reference Ranges and Biochemical Correlates in the General Population. Blood. 2011;117(25):e218-25.

Higgins PD, Rockey DC. Iron-Deficiency Anemia. Tech Gastrointest Endos. 2003;5(3):134-41.

Galesloot TE, Vermeulen SH, Geurts-Moespot AJ, Klaver SM, Kroot JJ, Van TD, et al. Serum Hepcidin: Reference Ranges and Biochemical Correlates in the General Population. Blood. 2011;117(25):E218-25.

De DI, Ward DM, Kaplan J. Hepcidin Regulation: Ironing Out the Details. The Journal of Clinical Investigation. 2007;117(7):1755-8.

Deicher R, Horl WH. New Insights into the Regulation of Iron Homeostasis. European J Clinical Investi. 2006;36(5):301-9.

Collins JF, Wessling-Resnick M, Knutson Md. Hepcidin Regulation of Iron Transport. J Nutrition. 2008;138(11):2284-8.

Hugman A. Hepcidin: An Important New Regulator of Iron Homeostasis. Clinical Adnet Laboratory Haematology. Haematologica. 2006;28(2):75-83.

Roe MA, Collings R, Dainty JR, Swinkels DW, Tait SJ. Plasma Hepcidin Concentrations Significantly Predict Inter individual Variation in Iron Absorption in Healthy Men. American J Clinic Nutrit. 2009;89(4):1088-91.

Theurl I, Aigner E, Theurl M, Nairz M, Seifert M, Schroll A, et al. Regulation of Iron Homeostasis in Anemia of Chronic Disease and Iron Deficiency Anemia: Diagnostic and Therapeutic Implications. Blood. 2009;113(21):5277-86.

Cheng PP, Jiao XY, Wang XH, Lin JH, Cai YM. Hepcidin Expression in Anemia of Chronic Disease and Concomitant Iron Deficiency Anemia. Clin Exp Med. 2011;11:33-42.

Pasricha SR, Mcquilten Z, Westerman M, Keller A, Nemeth E, Ganz T, et al. Serum Hepcidin as a Diagnostic Test of Iron Deficiency in Premenopausal Female Blood Donors. Haematologica. 2011;96(8):1098-1105.

Kim J, Yonghak S, Chunhwa I. Serum Pro-Hepcidin as a Predictor of Iron Deficiency in Anemic Patients. Lab Med. 2011;1(2):88-93.

Vokurka M, Krijt J, Sulc K, Necas E. Hepcidin Levels in Mouse Liver Respond to Inhibition of Erythropoiesis. Physiol Res. 2006;55:667-74.

Choi HS, Song SH, Lee JH, Kim HJ, Yang HR. Serum Hepcidin Levels and Iron Parameters in Children with Iron Deficiency. Korean J Hematol. 2012;47:286-92.

Goodnough JB, Ramos E, Nemeth E, Ganz T. Inhibition of hepcidin transcription by growth factors. Hepatol. 2012;56:1-9.

Kroot JJ, Van Herwaarden AE, Tjalsma H, Jansen RT, Hendriks JC, Swinkels DW. Second Round Robin For Plasma Hepcidin Methods: First Steps Toward Harmonization. Amer J Hematol. 2012;87(10):977-83.

Angelo GD. Role of hepcidin in the pathophysiology and diagnosis of anemia. Blood Research. 2013;48:10-5.

Oates PS. The Relevance of the Intestinal Crypt Enterocyte in Regulating Iron Absorption. Eur J Physiol. 2007;455(2):201-13.

Pak M, Lopez Ma, Gabayan V, Ganz T, Rivera S. Suppression of Hepcidin during Anemia Requires Erythropoietic Activity. Blood. 2006;108(12):3730-5.