Serum Hepcidin Quantification in Stroke in β-Thalassemia and Rheumatoid Arthritis Patients

Abstract

Background and Purpose: Anemia occurs often in different conditions, associated with iron metabolism and flowing in a number of diseases. Variations in serum levels of iron is due to a number of reasons, such as bleeding from the gastrointestinal tract, inflammation, production of inflammatory cytokines, deposition of iron in various tissue structures, and etc. Oxidative stress plays an important role in neuronal injuries caused by cerebral ischemia. We aimed to quantify serum hepcidin in rheumatoid arthritis patients with ischemic stroke and β-thalassemia with stroke and evaluate peptide changes in combination of two diseases.Methods: For a period of two years 138 patients with ischemic stroke were enrolled. They were separated into three groups -49 with ischemic stroke, caused by vascular reasons (ISVR), 43 patients with rheumatoid arthritis (RA) and 46 β-thalassemia cases (BTM). Their results were compared to age and gender matched healthy controls. Established parameters from rheumatoid arthritis and β-thalassemia cases were compared with RA and BTM patients without stroke. Statistical analysis of established results was performed using Pearson's correlation and Student's paired t-test. Results:We found statistically different results from included groups for serum hepcidin levels. They differ in case if an acute stroke occurs during rheumatoid arthritis or β-thalassemia. Serum hepcidin levels statistically differ in three ischemic stoke groups: ISVR 87.6±9.4 µg/L, RA 19.4±0.9 µg/L and BTM 7.9±1.1 µg/L (P<0.001). In patients with RA and BTM without stroke hepcidin shows serum concentrations from 35.6±1.4 µg/L and 0.95±0.3 µg/L (P<0.001). In healthy controls we quantified serum hepcidin as 22.7±5.1 µg/L. Conclusion:Our study in patients with acute stroke, rheumatoid arthritis and stroke and β-thalassemia and stroke confirms the ability of verified immunochemical method for evaluation of iron homeostasis. It provides a basis for the correct choice of therapeutic approach in anemia treatment. Rheumatoid arthritis increases serum hepcidin levels in stroke; in patients with β-thalassemia peptide's concentration decreases. Dissimilar diseases are accompanied with iron disorders, thereby masking the state of this trace element in human body.