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Serum and Urinary Hepcidin for Diagnosing Iron-deficiency Anemia in Under-5 Children

Dewan, Pooja, MBBS, MD, FIAP*; Dixit, Anupriya, MBBS, MD*; Gomber, Sunil, MBBS, MD, DCH, DNB, FIAP*; Kotru, Mrinalini, MBBS, MD, DM; Banerjee, Basu D., MSc, PhD; Tyagi, Vipin, MSc§; Malhotra, Rajeev K., PhD

Journal of Pediatric Hematology/Oncology: May 2019 - Volume 41 - Issue 4 - p e216–e220
doi: 10.1097/MPH.0000000000001320
Online Articles: Original Articles

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:

Received May 23, 2018

Accepted August 26, 2018

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