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Vitamin D Decreases Hepcidin and Inflammatory Markers in Newly Diagnosed Inflammatory Bowel Disease Paediatric
Hadar Moran-Lev1,2, Tut Galai2, Anat Yerushalmy-Feler2
1Department of Pediatrics, Dana Dwek Children's Hospital, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Insights
Vitamin D treatment significantly reduced high hepcidin levels in children with inflammatory bowel disease (IBD) and anemia. This suggests vitamin D may help treat anemia in pediatric IBD patients.
Area of Science:
- Pediatric Gastroenterology
- Hematology
- Endocrinology
Background:
- Hepcidin's role in pediatric inflammatory bowel disease (IBD) and anemia is unclear.
- Vitamin D is known to suppress hepcidin expression.
Purpose of the Study:
- Assess serum hepcidin levels in newly diagnosed pediatric IBD patients.
- Evaluate the effect of vitamin D treatment on hepcidin levels in these patients.
Main Methods:
- Recruited 85 children (40 IBD, 45 controls).
- Measured IL-6, CRP, hepcidin, iron, and vitamin D levels at baseline.
- Treated IBD patients with mild-to-moderate symptoms with vitamin D for 2 weeks and repeated tests.
Main Results:
- IBD children had higher hepcidin, IL-6, CRP, and platelet counts, and lower iron and hemoglobin.
- Vitamin D treatment increased 25-(OH)-D levels by 40%.
- Hepcidin, CRP, and ferritin levels decreased significantly (81%, 81%, and 40%) after vitamin D treatment.
Conclusions:
- Pediatric IBD patients exhibit elevated serum hepcidin levels compared to controls.
- Vitamin D treatment led to a significant reduction in hepcidin concentration.
- Vitamin D may be a potential therapeutic agent for managing anemia in pediatric IBD.
Background And Aims:
The role of hepcidin in inflammatory bowel disease [IBD] in children with anaemia is poorly understood. However, it has been shown that vitamin D suppresses hepcidin expression. We aimed to assess serum hepcidin levels and the effect of vitamin D treatment on those levels in newly diagnosed IBD paediatric patients.
Methods:
Eighty-five children were prospectively recruited in the Dana-Dwek Children's Hospital [40 newly diagnosed IBD, 45 healthy controls, 47% female, mean age 13.5 ± 3.4 years]. Blood samples for measurement of interleukin 6 [IL-6], C-reactive protein [CRP], hepcidin, iron parameters and 25-hydroxyvitamin D [25-(OH)-D] levels were obtained at baseline. Patients with mild-to-moderate signs and symptoms of IBD were treated with 4000 units of vitamin D daily for 2 weeks, after which the blood tests were repeated.
Results:
Basal hepcidin, IL-6, CRP and platelet counts were significantly higher, and haemoglobin, serum iron and transferrin levels were significantly lower in the IBD children compared to controls [p < 0.001]. Eighteen patients completed 2 weeks of treatment with vitamin D. Following treatment, serum 25-(OH)-D concentrations increased by 40% [from 22.5 to 32.5 ng/mL], and serum hepcidin, CRP and ferritin levels decreased by 81%, 81% and 40% [from 33.9 to 6.7 ng/mL, from 23.9 to 4.7 mg/L, and from 27 to 16 ng/mL, respectively] [p ≤ 0.001].
Conclusion:
Serum hepcidin levels were significantly higher in IBD paediatric patients compared to controls. Following vitamin D treatment, serum hepcidin concentration decreased significantly. These findings suggest a potential role for vitamin D in treating anaemia in IBD children.
Clinicaltrials.Gov Number:
NCT03145896.
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