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Serum hepcidin concentrations in relation to iron status in children with type 1 diabetes

Mirjam Vreugdenhil1, Marjolijn D Akkermans1, Rachel P L van Swelm2

  • 1Department of Pediatrics, Juliana Children's Hospital/Haga Teaching Hospital, The Hague, The Netherlands.

Pediatric Hematology and Oncology
|October 7, 2020
PubMed

Insights

In type 1 diabetes (T1D) children, hepcidin levels were similar in functional iron deficiency (FID) and normal iron status groups. Single hepcidin measurements are not sufficient for assessing FID in T1D.

Area of Science:

  • Pediatric Endocrinology
  • Hematology
  • Metabolic Disorders

Background:

  • Chronic low-grade inflammation in type 1 diabetes (T1D) may elevate hepcidin, potentially causing functional iron deficiency (FID).
  • Understanding iron status in T1D is crucial for managing potential complications.

Purpose of the Study:

  • To investigate hepcidin concentrations in T1D children with FID compared to those with normal iron status and absolute iron deficiency (AID).
  • To assess the utility of hepcidin in identifying FID in pediatric T1D patients.

Main Methods:

  • Cross-sectional study of 215 T1D children (median age 13.7 years).
  • FID defined by elevated zinc protoporphyrin/heme ratio and/or red blood cell distribution width; AID by low serum ferritin.
  • Serum hepcidin measured by mass-spectrometry; post-hoc analyses used transferrin saturation and reticulocyte hemoglobin content.

Main Results:

  • Hepcidin concentrations were significantly higher in FID patients than in AID patients (p < 0.001).
  • Hepcidin levels did not differ between FID patients and those with normal iron status, regardless of FID definition.
  • Median hepcidin: 1.8 nmol/L (normal), 0.4 nmol/L (AID), 1.6 nmol/L (FID).

Conclusions:

  • Single hepcidin measurements appear insufficient for assessing FID in children with T1D.
  • Variability in hepcidin influenced by multiple factors may explain findings.
  • Future studies with longitudinal hepcidin measurements might offer better insights into FID in T1D.

Keywords:
Childrenhepcidiniron deficiencyiron statustype 1 diabetes

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