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Normal range and predictors of serum erythroferrone in infants

Fredrik Bäckström1, Anna Chmielewska1, Magnus Domellöf1

  • 1Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.

Pediatric Research
|April 17, 2023
PubMed

Insights

Erythroferrone (ERFE) levels in infants are established for the first time, showing low concentrations at birth that increase over the first year. Infant ERFE levels do not correlate with iron status, suggesting different iron regulation compared to adults.

Area of Science:

  • Pediatric Hematology
  • Iron Metabolism
  • Endocrinology

Background:

  • Erythroferrone (ERFE) is a hepcidin-regulating hormone linked to erythropoiesis and iron needs in adults.
  • Its role and concentration patterns in infants are not well understood.

Purpose of the Study:

  • To determine serum concentrations of ERFE in healthy infants during their first year of life.
  • To identify predictors of ERFE levels, including birth weight and iron supplementation.

Main Methods:

  • ERFE levels were measured in 45 normal birth weight (NBW) and 136 marginally low birth weight (LBW) infants at four time points from 6 weeks to 12 months.
  • LBW infants received either iron supplementation or placebo between 6 weeks and 6 months.

Main Results:

  • ERFE concentrations were low at birth, rising throughout the first year, with established reference ranges for NBW infants.
  • LBW infants had higher ERFE at 6 weeks but lower at 12 months compared to NBW infants; iron supplementation had minimal effect.
  • Correlations between ERFE and erythropoietic or iron status markers were weak and inconsistent in infants.

Conclusions:

  • This study provides the first normal ranges for erythroferrone in healthy infants.
  • ERFE in infants appears to be dissociated from iron status and erythropoiesis markers, unlike in adults.
  • Findings suggest distinct infant iron homeostasis regulation and highlight the need for infant-specific studies, potentially impacting anemia management.
Abstract

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