Iron Regulatory Hormone Hepcidin Decreases in Chronic Heart Failure Patients With Anemia

Background: The etiology of anemia is still unclear in patients with chronic heart failure (CHF). Hepcidin is an iron regulatory peptide that is synthesized in the liver to suppress iron absorption and utilization. Hepcidin synthesis is suppressed by anemia, hypoxia and erythropoiesis, and induced b...

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Bibliographic Details
Published in:Circulation Journal 2010, Vol.74(2), pp.301-306
Main Authors: Matsumoto, Mika, Tsujino, Takeshi, Lee-Kawabata, Masaaki, Naito, Yoshiro, Akahori, Hirokuni, Sakoda, Tsuyoshi, Ohyanagi, Mitsumasa, Tomosugi, Naohisa, Masuyama, Tohru
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Anemia - blood
Anemia of inflammation
Antimicrobial Cationic Peptides - blood
Biomarkers - blood
Case-Control Studies
Chronic Disease
Chronic heart failure
Down-Regulation
Erythropoietin - blood
Female
Ferritins - blood
Heart Failure - blood
Hepcidin-25
Hepcidins
Humans
Inflammation Mediators - blood
Interleukin-6
Interleukin-6 - blood
Linear Models
Male
Middle Aged
Prospective Studies
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Summary:Background: The etiology of anemia is still unclear in patients with chronic heart failure (CHF). Hepcidin is an iron regulatory peptide that is synthesized in the liver to suppress iron absorption and utilization. Hepcidin synthesis is suppressed by anemia, hypoxia and erythropoiesis, and induced by inflammation. Inflammatory cytokines, such as interleukin-6 (IL-6), increase the synthesis of hepcidin, resulting in anemia of inflammation (AI). The serum hepcidin concentration in CHF patients with anemia was measured in order to better understand anemia in CHF. Methods and Results: Serum hepcidin-25, erythropoietin (EPO), ferritin and IL-6 concentrations were measured in 61 CHF patients. Among these patients, 36 patients had anemia. A group of 16 patients without cardiac disease or anemia were recruited as controls. Serum IL-6 and EPO were higher and hepcidin-25 was lower in CHF patients with anemia than in controls. Hepcidin-25 correlated with EPO and ferritin but not with IL-6. Results of multivariable regression analysis showed that independent predictors of serum hepcidin-25 included EPO and ferritin but not IL-6. Conclusions: Serum hepcidin-25 concentrations were regulated by iron storage and erythropoiesis but not by IL-6 in CHF patients with anemia. These findings might indicate that AI is a minor cause of anemia in CHF. (Circ J 2010; 74: 301-306)
ISSN:1346-9843
1347-4820
DOI:10.1253/circj.CJ-09-0663