P605 Serum hepcidin and its relation to anaemia in inflammatory bowel disease
R. Dudkowiak*1, K. Neubauer1, P. Petryszyn2, E. Poniewierka1
1Wroclaw Medical University, Department of Gastroenterology and Hepatology, Wroclaw, Poland, 2Wroclaw Medical University, Clinical Pharmacology, Wroclaw, Poland
Hepcidin is the most important mediator of anaemia. Stimulation of hepcidin production has a casual role in the pathogenesis of the aneamia of inflammation. Anaemia is the most common complication of inflammatory bowel disease (IBD). Anaemia in IBD is pathogenically complex, with several factors contributing to its development. Because the right diagnosis of anaemia in IBD often presents a challenge, combination of several hematimetric and biochemical parameters should be used and hepcidin is one of them.
The study comprised 51 patients with CD (24 women, 27 men) and 46 patient with UC (23 women, 23 men) hospitalized in gastroenterology ward. Serum hepcidin levels were measured using a commercially available ELISA. All patient underwent blood investigation comprising hemoglobin (Hgb), ferritin, transferrin, serum iron and serum soluble transferrin receptor levels. Anaemia defined as a Hgb level of less than 12.0 g/dl in females and less than 13.0 g/dl in males has been established in 18 patients with CD (35%) and 22 patients with UC (48%). According to Weiss and Goodnough  ferritin, transferrin saturation and sTfR-Fer Index were used for further group stratification on iron deficient anaemia (IDA), anemia of chronic disease (ACD) and mixed form (MIX).
The mean hepcidin level in patients with CD was 51,74 ng/ml compared with a mean of 43,38 ng/ml in patients with UC and this difference was statistically significant (p=0,039). Significantly more cases of hepcidin values above the upper limit of norm was observed in the CD group (23 vs. 12). There was no statistically significant difference in the distribution of hepcidin in relation to sex, both within groups and between them (Fig.1)
“Hepcidin values in groups with respect to gender.”
. The group of anaemic patients consisted of 19 patients with MIX, 13 patients with IDA and 8 with ACD. A statistically significant difference between patients with CD and UC was demonstrated in the case of ACD and MIX (p <0.02). The mean hepcidin level was the highest in patients with ACD (63,32 ± 24,35 ng/ml) and statistically significant compared to IBD patient without anaemia (p=0,038) and patient with MIX (p=0,033). The relation between mean hepcidin level in patient with ACD and IDA (43,4 ± 16,4) was not statistically significant (p=0,062).
Our data suggest that high hepcidin level is more specific for ACD and IDA/ACD. This relationship should influence on the choice of an appropriate method of treatment anemia, depending on the disease activity in patients with IBD.
 Weiss G, Goodnough LT, (2005), Anemia of chronic disease, N Engl J Med 352, 1011-23.