Evaluation of hepcidin as a potential biomaker for the differential diagnosis of iron deficiency anaemia and anaemia of chronic disease at Ndola central hospital,Zambia

Abstract

Anaemia affects approximately 1.62 billion people globally corresponding to 24.8% of the world’s population. Iron deficiency anaemia (IDA) and anaemia of chronic disease (ACD) are the most common forms of anaemia. A hormone produced by the liver, hepcidin, is the primary regulator of iron homeostasis and its production increases in ACD and decreases in IDA. Usually, ACD and IDA coexist and sometimes look identical on peripheral blood smears. The current study aims to evaluate the diagnostic value of hepcidin to predict ACD from IDA as well as the diagnostic value of hepcidin to predict ACD from a combination of IDA and ACD. Specimens presenting with haematological indices suggestive of IDA and/or ACD following World Health Organisation (WHO) standard case definitions were identified among samples coming to the Haematology laboratory for routine investigations. Serum hepcidin, serum ferritin, serum iron and total iron binding capacity (TIBC) were assessed. Demographic data was obtained from specimen requisition forms. Of the 66 participants, 62.1% (n = 41) were females and IDA was more common among females (36.4%) than males (6.1%) while ACD was more common in males (19.7%) than females (12.1%). Anaemia of chronic disease participants had significantly higher hepcidin levels than IDA and IDA/ACD (p<0.001). There was a significant positive correlation between serum hepcidin and serum ferritin levels (p < 0.001). We found that IDA participants had significantly lower hepcidin levels than ACD and IDA/ACD combined. Therefore, serum hepcidin could be considered in diagnosing and distinguishing ACD from IDA or IDA/ACD as it also had high diagnostic sensitivity and specificity compared to other markers. Key words: Hepcidin; Iron Deficiency Anaemia; Anaemia of chronic Disease.