Bone marrow iron estimation remains the gold standard for diagnosing iron-deficiency anemia (IDA); serum ferritin, total iron-binding capacity, and transferrin saturation are routinely used as surrogate markers of IDA. However, these tests are marred by problems like poor specificity and sensitivity. Recently, hepcidin, a protein hormone synthesized in the liver and excreted in urine, has been shown to be related to iron status. We estimated the serum and urinary hepcidin levels in healthy children 6 to 60 months of age with (n=30) and without IDA (n=30). The mean (SD) serum hepcidin levels in children with IDA were significantly lower than those in children without IDA (3.03 [1.06] vs. 4.78 [3.94] ng/mL; P=0.02). The mean (SD) urinary hepcidin levels were also significantly lower in children with IDA than those in children without IDA (2.29 [0.53] vs. 2.79 [0.75] ng/mL; P=0.004). Performance of urinary and serum hepcidin compared with serum ferritin (<12 µg/L) for diagnosing IDA in terms of area under the receiver operating characteristic curve was 0.704 (P=0.007) and 0.59 (P=0.22), respectively. Serum hepcidin is not useful for diagnosing IDA in under-5 children. In contrast, urinary hepcidin holds promise as a noninvasive diagnostic tool for IDA in under-5 children.
Departments of *Pediatrics
§Environmental Biochemistry and Molecular Biology Laboratory, Department of Biochemistry, University College of Medical Sciences
∥All India Institute of Medical Sciences, Delhi, India
Indian Council of Medical Research granted INR 25,000/ to Dr Anupriya Dixit for the conduct of this research work which was utilized toward purchasing the kits for estimation of hepcidin.
The authors declare no conflict of interest.
Reprints: Pooja Dewan, MBBS, MD, FIAP, Tower 7 G02, Parsvnath Prestige 2, Srishti, Sector 93A, Noida 201304, Uttar Pradesh, India (e-mail: firstname.lastname@example.org).
Received May 23, 2018
Accepted August 26, 2018