Hepcidin as a diagnostic biomarker of iron deficiency anemia during pregnancy

Objectives: Hepcidin hormone production is suppressed in the case of iron deficiency. The role of hepcidin as a hormone in iron metabolism along with its diagnostic cut-off values and its sensitivity and specificity among pregnant women with iron deficiency anemia (IDA) was examined in this study. Methods: In this case-control study, three groups of pregnant subjects were included according to the following criteria: cases/patient group: pregnant women with IDA based on, Hb < 11.5 g/dl, S ferritin < 10 ng/ml, TS%<15%; positive control group: pregnant women with non-IDA based on, Hb < 11.5 g/dl, S ferritin > 10 ng/ml, TS%>15%; and negative control group: included non-anemic apparently healthy pregnant women based on, Hb > 11.5 g/dl, S ferritin > 10 ng/ml, TS%>15%. Results: The serum hepcidin was significantly lower in pregnant women with IDA (0.34 ng/ml) compared to its level in pregnant women with non-IDA (23.48 ng/l) and apparently healthy pregnant women (13.86 ng/ml; p<.001). The study found a significant correlation between serum hepcidin and iron deficiency-related parameters with adjustment for study groups (p<.01). Moreover, the study found that serum hepcidin has good sensitivity in the range of 0.49-0.76 ng/ml (80.6-83.3%) and good specificity (76.2%) over positive IDA. Similar results were found for serum hepcidin over negative control group (0.49-0.83 ng/ml; sensitivity: 80.6-83.3%; specificity: 75.8-78.8%). Conclusions: This study suggests that serum hepcidin is superior to hemoglobin, serum iron, serum ferritin, TS, and TIBC as an indicator of IDA in pregnant women. Study register: 24012018-1 on 24 January 2018.