Fig 1.
Correlation of serum hepcidin levels with parameters of the iron status.
Serum hepcidin levels of the three patient groups of non-anemic controls, anemic patients treated with IV iron and anemic patients without IV iron treatment, were correlated to the iron parameters. The x- and y-scales are depicted logarithmic (log10). Values of “0” were replaced with 0.01 in order to depict them in the logarithmic graph. Serum hepcidin levels correlated with (A) serum iron levels (n = 146 XY-pairs (n = 9 non-anemics, n = 58 anemics without IV iron, n = 79 anemics plus IV iron); r = 0.19; Spearman *p = 0,02), (B) transferrin protein levels (n = 143 XY-pairs (n = 6 non-anemics, n = 58 anemics without IV iron, n = 79 anemics plus IV iron); r = -0,55; Spearman *p<0.0001), (C) ferritin levels (n = 143 XY-pairs (n = 6 non-anemics, n = 58 anemics without IV iron, n = 79 anemics plus IV iron); r = 0,75 Spearman *p<0.0001) and (D) transferrin saturation (n = 142 XY-pairs (n = 5 non-anemics, n = 58 anemics without IV iron, n = 79 anemics plus IV iron); r = 0.37; Spearman *p<0.0001).
Fig 2.
Delta Hgb is higher in anemic patients who received IV iron.
Delta Hgb values represent the difference of the hemoglobin value that was measured directly prior to surgery and the baseline hemoglobin level. (A) Baseline Hgb values were higher in non-anemic patients (14.3g/dl [13.48, 14.9], n = 48) than in both anemic patients with (10.8g/dl [10.05, 11.7], n = 79, *p<0.0001) and without (11.3g/dl [10.1, 11.93], n = 64, #p<0.0001) IV iron treatment. (B) Delta Hgb values were higher in anemic patients who were administered with IV iron (n = 40) (0.45g/dl [0.05, 1.05] vs. 0.1g/dl [-0.48, 0.73], *p = 0.03) compared to anemic patients without IV iron treatment (n = 26). (C) Patients with an increase in Hgb levels of ≥0.6g/dl were considered responders. Delta Hgb values were higher in the group of responders (1.1g/dl [0.8, 1.45], n = 19 patients) compared to the delta Hgb values in the group of anemic non-responders (0.1g/dl [-0.3, 0.3], n = 21 patients).
Table 1.
Multivariable regression analysis for potential confounding effects.
Table 2.
Characteristics of responders and non-responders.
Fig 3.
Comparison of the inflammatory parameters leukocytes and CRP in the groups of responders and non-responders.
CRP levels and leukocytes as parameters of inflammation were compared between the groups of responders and non-responders. (A) CRP levels were higher in the group of non-responders (responders: 0.4mg/dl [0.4, 0.5], n = 11, vs. non-responders: 1.6mg/dl [0.4, 2.5], n = 13, *p = 0.04). (B) Leucocytes were higher in the group of non-responders, too (responders: 5.87 *103/μl [5.2, 7.1], n = 19, vs. non-responders: 7.84 *103/μl [6.39, 8.6], n = 21, *p = 0.04).
Fig 4.
Comparison of hepcidin levels in the groups of responders and non-responders.
Serum hepcidin levels were lower in anemic patients with a good response to IV iron (2.07ng/ml [0.25, 7.97], n = 19) compared to anemic patients with an impaired response (10.62ng/ml [3.93, 34.77], n = 21; *p = 0.04).
Table 3.
Multivariable regression analysis of delta Hgb.
Table 4.
Four studies that analyzed hepcidin as a potential biomarker and/or the correlation between hepcidin and ferritin.
Table 5.
Two studies that analyzed hepcidin as a potential biomarker and/or the correlation between hepcidin and ferritin.