Abstract
Anemia of chronic disease (ACD) and iron deficiency anemia (IDA) are the two most important types of anemia in rheumatoid arthritis (RA). Functional iron deficiency in ACD can be attributed to overexpression of the main iron regulatory hormone hepcidin leading to diversion of iron from the circulation into storage sites resulting in iron-restricted erythropoiesis. The aim is to investigate the role of circulating hepcidin and to uncover the frequency of IDA in RA. The study included 51 patients with RA. Complete blood counts, serum iron, total iron binding capacity, ferritin, and hepcidin-25 were assessed. ACD was found in 37.3% of patients, IDA in 11.8%, and combined (ACD/IDA) in 17.6%. Serum hepcidin was higher in ACD than in control and the other groups (P≤0.001). It was strongly and positively correlated with ferritin (P<0.001), while hemoglobin, serum iron, and total iron binding capacity were negatively correlated with hepcidin (P=0.016, 0.022 and <0.001, respectively). High serum hepcidin was significantly associated with ACD in RA. IDA alone or combined with ACD was encountered in about a third of patients.
Highlights
The median levels of serum iron and transferrin saturation percentage were lowest and subnormal in Anemia of chronic disease (ACD)/iron deficiency anemia (IDA) followed by IDA and were normal in control and NA groups (P≤0.001)
N groups, and in IDA and ACD/IDA groups o the hepcidin levels were less than that in non-anemic and control groups with statise tically significant differences (P
The presence of IDA in rheuman toid arthritis (RA) patients was associated with a lower ESR value and anemia in RA would be much higher
Summary
This case-control study included 51 patients (10 males and 41 females) with RA All patients fulfilled both the 1987 revised criteria for the classification of RA of the American College of Rheumatology data analysis, and final approval of the script; SS, clinical diagnosis of RA patients, measuring disease-activity score 28, review and approval of the final script; WK, sample collection, major part of laboratory work, drafting and approval of the manuscript. The median levels of serum iron and transferrin saturation percentage were lowest and subnormal in ACD/IDA followed by IDA and were normal in control and NA groups (P≤0.001).
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