Decreased hepcidin levels are associated with low steady-state hemoglobin in children with sickle cell disease in Tanzania

<strong>Background</strong> The contribution of hepcidin as a regulator of iron metabolism &amp; erythropoiesis on the severity of anemia in sickle cell disease (SCD) remains poorly characterized, especially in Sub-Saharan African populations. The aims of the study were to determine...

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Main Authors: Lee, N, Makani, J, Tluway, F, Makubi, A, Armitage, AE, Pasricha, S-R, Drakesmith, H, Prentice, AM, Cox, SE
Format: Journal article
Language:English
Published: Elsevier 2018
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author Lee, N
Makani, J
Tluway, F
Makubi, A
Armitage, AE
Pasricha, S-R
Drakesmith, H
Prentice, AM
Cox, SE
author_facet Lee, N
Makani, J
Tluway, F
Makubi, A
Armitage, AE
Pasricha, S-R
Drakesmith, H
Prentice, AM
Cox, SE
author_sort Lee, N
collection OXFORD
description <strong>Background</strong> The contribution of hepcidin as a regulator of iron metabolism &amp; erythropoiesis on the severity of anemia in sickle cell disease (SCD) remains poorly characterized, especially in Sub-Saharan African populations. The aims of the study were to determine if hepcidin is associated with severity of steady-state anemia in SCD and to investigate factors associated with hepcidin and anemia in SCD. <strong>Methods</strong> Archived samples from 199 Tanzanian children, 56% boys aged 3–18 with laboratory-confirmed SCD were analysed based on recorded averaged steady-state hemoglobin (ASSH) quartiles (lowest vs. highest). Univariable and multivariable logistic regression was used to assess associations with ASSH quartiles. <strong>Findings</strong> In univariable analysis, hepcidin &lt;5·5 ng/mL was associated with increased odds of being in the lowest ASSH quartile (OR 2·20; 95%CI 1·2–3·93) but which was limited to girls (OR 4·85, 95%CI 1·79–13·09, p = .046 for interaction). In multivariable analyses including either reticulocyte percentage or erythropoietin, lower hepcidin remained significantly associated with lowest ASSH quartile, although the hepcidin-sex interaction no longer reached statistical significance. No associations with ASSH quartile were observed for markers of inflammation, hemolysis or potential iron markers except for microcytosis, associated with higher ASSH, but which was confounded by reticulocyte percentage and alpha-thalassaemia status. <strong>Interpretation</strong> Hepcidin is lower in more severely anaemic children with SCD independent of inflammation or markers of erythropoiesis.
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spelling oxford-uuid:c0c31632-3bc3-499e-b09e-ced1aed42ba22022-03-27T05:56:46ZDecreased hepcidin levels are associated with low steady-state hemoglobin in children with sickle cell disease in TanzaniaJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:c0c31632-3bc3-499e-b09e-ced1aed42ba2EnglishSymplectic Elements at OxfordElsevier2018Lee, NMakani, JTluway, FMakubi, AArmitage, AEPasricha, S-RDrakesmith, HPrentice, AMCox, SE<strong>Background</strong> The contribution of hepcidin as a regulator of iron metabolism &amp; erythropoiesis on the severity of anemia in sickle cell disease (SCD) remains poorly characterized, especially in Sub-Saharan African populations. The aims of the study were to determine if hepcidin is associated with severity of steady-state anemia in SCD and to investigate factors associated with hepcidin and anemia in SCD. <strong>Methods</strong> Archived samples from 199 Tanzanian children, 56% boys aged 3–18 with laboratory-confirmed SCD were analysed based on recorded averaged steady-state hemoglobin (ASSH) quartiles (lowest vs. highest). Univariable and multivariable logistic regression was used to assess associations with ASSH quartiles. <strong>Findings</strong> In univariable analysis, hepcidin &lt;5·5 ng/mL was associated with increased odds of being in the lowest ASSH quartile (OR 2·20; 95%CI 1·2–3·93) but which was limited to girls (OR 4·85, 95%CI 1·79–13·09, p = .046 for interaction). In multivariable analyses including either reticulocyte percentage or erythropoietin, lower hepcidin remained significantly associated with lowest ASSH quartile, although the hepcidin-sex interaction no longer reached statistical significance. No associations with ASSH quartile were observed for markers of inflammation, hemolysis or potential iron markers except for microcytosis, associated with higher ASSH, but which was confounded by reticulocyte percentage and alpha-thalassaemia status. <strong>Interpretation</strong> Hepcidin is lower in more severely anaemic children with SCD independent of inflammation or markers of erythropoiesis.
spellingShingle Lee, N
Makani, J
Tluway, F
Makubi, A
Armitage, AE
Pasricha, S-R
Drakesmith, H
Prentice, AM
Cox, SE
Decreased hepcidin levels are associated with low steady-state hemoglobin in children with sickle cell disease in Tanzania
title Decreased hepcidin levels are associated with low steady-state hemoglobin in children with sickle cell disease in Tanzania
title_full Decreased hepcidin levels are associated with low steady-state hemoglobin in children with sickle cell disease in Tanzania
title_fullStr Decreased hepcidin levels are associated with low steady-state hemoglobin in children with sickle cell disease in Tanzania
title_full_unstemmed Decreased hepcidin levels are associated with low steady-state hemoglobin in children with sickle cell disease in Tanzania
title_short Decreased hepcidin levels are associated with low steady-state hemoglobin in children with sickle cell disease in Tanzania
title_sort decreased hepcidin levels are associated with low steady state hemoglobin in children with sickle cell disease in tanzania
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AT tluwayf decreasedhepcidinlevelsareassociatedwithlowsteadystatehemoglobininchildrenwithsicklecelldiseaseintanzania
AT makubia decreasedhepcidinlevelsareassociatedwithlowsteadystatehemoglobininchildrenwithsicklecelldiseaseintanzania
AT armitageae decreasedhepcidinlevelsareassociatedwithlowsteadystatehemoglobininchildrenwithsicklecelldiseaseintanzania
AT pasrichasr decreasedhepcidinlevelsareassociatedwithlowsteadystatehemoglobininchildrenwithsicklecelldiseaseintanzania
AT drakesmithh decreasedhepcidinlevelsareassociatedwithlowsteadystatehemoglobininchildrenwithsicklecelldiseaseintanzania
AT prenticeam decreasedhepcidinlevelsareassociatedwithlowsteadystatehemoglobininchildrenwithsicklecelldiseaseintanzania
AT coxse decreasedhepcidinlevelsareassociatedwithlowsteadystatehemoglobininchildrenwithsicklecelldiseaseintanzania