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Hepcidin is a relevant iron status indicator in infancy: results from a randomized trial of early vs. delayed cord
Staffan K Berglund1,2, Anna M Chmielewska3, Magnus Domellöf3
1Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden. staffan.berglund@umu.se.
Insights
Serum hepcidin effectively indicates infant iron status, particularly identifying iron deficiency (ID) in early infancy. Levels below 16 ng/mL at 4 months strongly suggest ID in infants.
Area of Science:
- Pediatric Nutrition
- Hematology
- Biomarker Discovery
Background:
- Iron deficiency (ID) is a prevalent concern in infancy.
- Accurate assessment of infant iron status is crucial for early intervention.
- Hepcidin's role as an iron status indicator in infants requires further elucidation.
Purpose of the Study:
- To evaluate serum hepcidin as a reliable indicator of iron status in infants.
- To determine the utility of hepcidin in detecting iron depletion and deficiency in early childhood.
Main Methods:
- Randomized controlled trial comparing early (<10s) versus delayed (≥180s) umbilical cord clamping (CC) in 400 term infants.
- Iron status assessment at 4 and 12 months of age.
- Serum hepcidin analysis in infants with iron depletion/deficiency and iron-replete controls, correlated with CC intervention and perinatal factors.
Main Results:
- Serum hepcidin levels were significantly lower in the early CC group at 4 and 12 months.
- Infants with iron deficiency (ID) showed lower hepcidin at 4 months.
- A hepcidin threshold of 16 ng/mL at 4 months effectively identified all cases of iron depletion/ID.
Conclusions:
- Serum hepcidin is a relevant biomarker for assessing iron status in early infancy.
- Hepcidin levels below 16 ng/mL at 4 months are indicative of iron deficiency in infants.
- This study suggests potential clinical utility of serum hepcidin for early detection of infant iron deficiency.
Background:
We aimed to evaluate whether serum hepcidin is a useful indicator of iron status in infants.
Methods:
Term infants (n = 400) were randomized to delayed (≥180 s) or early (≤10 s) cord clamping (CC). Iron status was assessed at 4 and 12 months. In all cases with iron depletion or iron deficiency (ID) (as defined in "Methods") (n = 30) and 97 randomly selected iron-replete infants, we analyzed hepcidin and explored its correlation to the intervention, iron status, and perinatal factors.
Results:
Serum hepcidin concentrations were significantly lower in the early CC group at both time points and in ID infants at 4 months. Median (2.5th-97.5th percentile) hepcidin in non-ID infants in the delayed CC group (suggested reference) was 64.5 (10.9-142.1), 39.5 (3.5-157.7), and 32.9 (11.2-124.2) ng/mL in the cord blood and at 4 and 12 months, respectively. The value of 16 ng/mL was a threshold detecting all cases of iron depletion/ID at 4 months. No similar threshold for ID was observed at 12 months. The strongest predictor of hepcidin at both ages was ferritin.
Conclusions:
Hepcidin is relevant as iron status indicator in early infancy and may be useful to detect ID. Levels <16 ng/mL at 4 months of age indicates ID.
Impact:
Serum hepcidin is a relevant indicator of iron status in early infancy. Normal reference in healthy infants is suggested in this study. Serum hepcidin may be useful in clinical practice to detect iron deficiency.
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