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- Title
The serum hepcidin:ferritin ratio is a potential biomarker for cirrhosis.
- Authors
Tan, Terrence C. H.; Crawford, Darrell H. G.; Franklin, Michael E.; Jaskowski, Lesley A.; Macdonald, Graeme A.; Jonsson, Julie R.; Watson, Melanie J.; Taylor, Paul J.; Fletcher, Linda M.
- Abstract
Background Serum hepcidin concentration is potentially affected by inflammation and iron stores in chronic liver disease ( CLD), but little is known about the relationship between hepcidin and the degree of hepatic fibrosis. We investigated the potential role of serum hepcidin as a biomarker of advanced liver disease. Methods Serum hepcidin was measured in 332 adults with CLD of varying aetiologies, 45 healthy and 50 non-liver disease patient controls. Liver biopsy data were available for 228 CLD subjects. Results Hepcidin was decreased in CLD patients compared with non-liver disease patient controls ( P < 0.0001) but not healthy controls, and was lowest in those with cirrhosis ( P < 0.0001). Serum hepcidin correlated with hepatic hepcidin mRNA expression in 91 biopsy samples available for genetic analysis ( r = 0.68, P < 0.0001). Hepcidin also correlated positively with serum ferritin concentration, transferrin saturation, ALT, serum albumin and haemoglobin, but negatively with serum bilirubin. The hepcidin:ferritin ratio was significantly lower in CLD subjects compared with healthy and disease controls, and decreased with each increase in the stage of fibrosis and siderosis. The hepcidin:ferritin ratio was associated with progressive fibrosis on linear regression, and a value of less than 0.1 was independently associated with cirrhosis on logistic regression analyses ( OR 5.54, P < 0.001). Receiver operating characteristic analysis showed the hepcidin:ferritin ratio was able to distinguish between F0 and F4 stages of fibrosis (area under receiver operating characteristic curve = 0.86). Conclusions The hepcidin:ferritin ratio is reduced in relation to increasing fibrosis in CLD and the use of this ratio may have potential future diagnostic implications as a marker of cirrhosis.
- Subjects
BLOOD proteins; HEPCIDIN; FERRITIN; CIRRHOSIS of the liver; ETIOLOGY of diseases; BIOMARKERS; BIOPSY; DIAGNOSIS
- Publication
Liver International, 2012, Vol 32, Issue 9, p1391
- ISSN
1478-3223
- Publication type
Article
- DOI
10.1111/j.1478-3231.2012.02828.x