Roles of ghrelin, hepcidin and HIF-2α in iron metabolism in iron deficiency anemia

Objectives This study investigates the roles of HIF-2 alpha, hepcidin, and ghrelin in iron deficiency anemia (IDA), the most widespread nutritional disorder globally. Material and methods Fifty IDA patients (18-50 years, BMI 19-25) and 40 healthy volunteers were studied. Hemoglobin, ferritin, hepcidin, HIF-2 alpha, and ghrelin levels were analyzed. Results IDA patients showed lower hemoglobin, ferritin, hepcidin, and ghrelin levels than the control group, but HIF-2 alpha levels were similar. Positive correlations were observed in both groups between hepcidin and HIF-2 alpha (p < 0.001), hepcidin and ghrelin (p < 0.001), and HIF-2 alpha and ghrelin (p < 0.001). Hemoglobin was correlated positively with HIF-2 alpha, and ferritin was correlated positively with HIF-2 alpha in the patient group. Conclusion The study suggests that the low hepcidin levels in IDA patients enhance iron absorption. The lack of significant HIF-2 alpha level differences may be due to the absence of chronic hypoxia in current hemoglobin levels of IDA patients. Moreover, the low ghrelin levels in patients and the correlations between ghrelin, hepcidin, and HIF-2 alpha in both groups indicate their involvement in iron metabolism.