Serum Prohepcidin and Hepcidin Levels in Patients with Ankylosing Spondylitis: A Prospective Study

Abstract

Background: Anemia is a common complication in patients with inflammatory diseases such as ankylosing spondylitis. Recent data suggest that hepcidin is a major mediator of anemia with a central role in iron homeostasis and metabolism. Objective; The aim of this study was to evaluate the serum levels of hepcidin and its prohormone, prohepcidin, in patients with ankylosing spondylitis in comparison with healthy controls. Methods: Forty patients with ankylosing spondylitis (13 with anemia and 27 without anemia), 20 healthy adults (HA) were prospectively enrolled. Complete blood count, erythrocyte sedimentation rate serum hepcidin, prohepcidin, iron, total iron binding capacity, ferritin, transferring and C-reactive protein levels were measured. Results: Serum prohepcidin and hepcidin levels were significantly higher in patients with ankylosing spondylitis compared with both healthy controls. (p<0.005). In patients with ankylosing spondylitis, positive correlation was determined between the serum hepcidin and prohepcidin levels (respectively;185±44, 73±7, p<0.05). Conclusions: To the best of our knowledge, this is the first report of serum prohepcidin and hepcidin levels in the patients with ankylosing spondylitis. Serum prohepcidin and hepcidin levels are closely associated with disease activity in patients with ankylosing spondylitis and might play a role in the pathogenesis of anemia of chronic disease associated with ankylosing spondylitis.