Hepcidin and Iron Status in Patients With Inflammatory Bowel Disease Undergoing Induction Therapy With Vedolizumab or Infliximab

被引：15

作者：

Loveikyte, Roberta ^{[1
,2
]}

Bourgonje, Arno R. ^{[2
]}

van der Reijden, Johannes J. ^{[1
]}

Bulthuis, Marian L. C. ^{[3
]}

Hawinkels, Lukas J. A. C. ^{[1
]}

Visschedijk, Marijn C. ^{[2
]}

Festen, Eleonora A. M. ^{[2
]}

van Dullemen, Hendrik M. ^{[2
]}

Weersma, Rinse K. ^{[2
]}

van Goor, Harry ^{[3
]}

van der Meulen-de Jong, Andrea E. ^{[1
]}

Dijkstra, Gerard ^{[2
]}

机构：

[1] Leiden Univ, Med Ctr, Dept Gastroenterol & Hepatol, C4-P,Postbus 9600, NL-2300 RC Leiden, Netherlands

[2] Univ Groningen, Univ Med Ctr Groningen, Dept Gastroenterol & Hepatol, Groningen, Netherlands

[3] Univ Groningen, Univ Med Ctr Groningen, Dept Pathol & Med Biol, Groningen, Netherlands

来源：

INFLAMMATORY BOWEL DISEASES | 2023年 / 29卷 / 08期

关键词：

hepcidin; inflammatory bowel disease; iron deficiency; iron deficiency anemia; biomarkers; SOLUBLE TRANSFERRIN RECEPTOR; SERUM HEPCIDIN; DEFICIENCY ANEMIA; CROHNS-DISEASE; COLITIS; ABSORPTION; CONSENSUS; CORRELATE; PATHWAYS; FERRITIN;

D O I：

10.1093/ibd/izad010

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Lay Summary Absolute iron deficiency is the primary determinant of hepcidin levels, even in an inflammatory state. Induction therapy can decrease hepcidin levels, which might improve iron bioavailability. Hence, hepcidin is a potential diagnostic iron deficiency biomarker that could assist therapeutic decision making. Background Hepcidin, the systemic iron regulator, could be critical in differentiating iron deficiency (ID) from functional iron restriction in inflammatory bowel disease (IBD). We assessed hepcidin as a diagnostic ID marker and explored the relationship between hepcidin and its regulators in patients with IBD undergoing induction therapy with infliximab (IFX) or vedolizumab (VEDO). Methods Patients with active IBD receiving induction therapy with IFX or VEDO were included. Serum samples at baseline and after 6 weeks of induction therapy were analyzed for hepcidin, inflammation- and hypoxia-associated cytokines, and oxidative stress. Data were analyzed by stratifying based on the response at week 14. Results were compared with samples from age- and sex-matched healthy control subjects. Results Patients receiving induction therapy with IFX (n = 71) or VEDO (n = 51) and healthy control subjects (n = 50) were included. At baseline, hepcidin correlated positively with ferritin and negatively with soluble transferrin receptor/log ferritin index (P < .001). ID was prevalent in 96.7% of patients who had hepcidin levels below the median. Hepcidin accurately identified ID: the area under the curve (hepcidin) was 0.89 (95% confidence interval, 0.82-0.95; P < .001). In total, 75.4% of patients responded to induction therapy; inflammation, hepcidin, and ferritin decreased significantly, while transferrin increased during induction therapy. These changes were observed only in patients who responded to the therapy. Conclusions Hepcidin levels in IBD are primarily determined by ID, even in an inflammatory state. In addition, induction therapy can decrease hepcidin levels, which might lead to better bioavailability of iron supplements. Therefore, hepcidin is a potential diagnostic ID biomarker that could assist therapeutic decision making.

引用

页码：1272 / 1284

页数：13

共 45 条

[1] Inflammation, but Not the Underlying Disease or Its Location, Predicts Oral Iron Absorption Capacity in Patients With Inflammatory Bowel Disease [J].