Startseite The iron regulatory hormone hepcidin is decreased in pregnancy: a prospective longitudinal study
Artikel
Lizenziert
Nicht lizenziert Erfordert eine Authentifizierung

The iron regulatory hormone hepcidin is decreased in pregnancy: a prospective longitudinal study

  • Susanne van Santen , Joyce J.C. Kroot , Gerard Zijderveld , Erwin T. Wiegerinck , Marc E.A. Spaanderman und Dorine W. Swinkels EMAIL logo
Veröffentlicht/Copyright: 14. Dezember 2012
Veröffentlichen auch Sie bei De Gruyter Brill

Abstract

Background: Iron deficiency is a commonly encountered problem in pregnancy and a frequently observed cause of pregnancy-associated anemia. We longitudinally assessed the iron regulatory hormone hepcidin during gestation and postpartum and related hepcidin to conventional indicators of iron status and inflammation.

Methods: Thirty-one healthy pregnant women were included and 81 blood samples from the three trimesters, directly and 6 weeks postpartum were analyzed for hemoglobin, the iron parameters: iron, total iron binding capacity, transferrin saturation, ferritin, soluble transferrin receptor and hepcidin, and CRP and leucocytes as markers of inflammation.

Results: Hepcidin concentration decreased gradually from the first to the second and third trimester to undetectable levels (≤0.5 nmol/L) which was paralleled by decreasing hemoglobin levels and changes in iron parameters indicative for iron deficiency. During gestation hepcidin levels correlated with iron parameters, but not with inflammatory markers. Postpartum, hepcidin increased immediately to levels similar as assessed at early pregnancy.

Conclusions: We conclude that hepcidin levels were suppressed during the second and third trimester of pregnancy, which was likely determined by the occurrence of iron deficiency. These data give insight in iron homeostasis during normal pregnancy.


Corresponding author: Prof. Dr. Dorine W. Swinkels, Department of Laboratory Medicine, Laboratory of Genetic Endocrine and Metabolic diseases (830 LGEM), Radboud University Nijmegen Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands, Phone: +31 24 3618957, Fax: +31 24 3541743

The authors would like to thank Siem Klaver for his assistance with sample collection and storage.

Conflict of interest statement

Authors’ conflict of interest disclosure: The authors stated that there are no conflicts of interest regarding the publication of this article.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

References

1. Wheeler S. Assessment and interpretation of micronutrient status during pregnancy. Proc Nutr Soc 2008;67:437–50.10.1017/S0029665108008732Suche in Google Scholar PubMed

2. Bothwell TH. Iron requirements in pregnancy and strategies to meet them. Am J Clin Nutr 2000;72:257S–64S.10.1093/ajcn/72.1.257SSuche in Google Scholar PubMed

3. Milman N. Prepartum anaemia: prevention and treatment. Ann Hemat 2008;87:949–59.10.1007/s00277-008-0518-4Suche in Google Scholar PubMed

4. WHO. World Health Organization. Iron deficiency anaemia, assessment, prevention, and control: a guide for programme managers 2001. Available at: http://www.who.int/nutrition/publications/en/ida_assessment_prevention_control.pdf. Accessed 19 June, 2012.Suche in Google Scholar

5. WHO. Worldwide prevalence of anaemia 1993–2005: WHO global database on anaemia 2008. Available at: http://whqlibdoc.who.int/publications/2008/9789241596657_eng.pdf. Accessed 19 June, 2012.Suche in Google Scholar

6. Kroot JJ, Tjalsma H, Fleming RE, Swinkels DW. Hepcidin in human iron disorders: diagnostic implications. Clin Chem 2011;57:1650–69.10.1373/clinchem.2009.140053Suche in Google Scholar PubMed

7. Nemeth E, Tuttle MS, Powelson J, Vaughn MB, Donovan A, Ward DM, et al. Hepcidin regulates cellular iron efflux by binding to ferroportin and inducing its internalization. Science 2004;306:2090–3.10.1126/science.1104742Suche in Google Scholar PubMed

8. Weiss G, Goodnough LT. Anemia of chronic disease. N Engl J Med 2005;352:1011–23.10.1056/NEJMra041809Suche in Google Scholar PubMed

9. Rehu M, Punnonen K, Ostland V, Heinonen S, Westerman M, Pulkki K, et al. Maternal serum hepcidin is low at term and independent of cord blood iron status. Eur J Haematol 2010;85:345–52.10.1111/j.1600-0609.2010.01479.xSuche in Google Scholar PubMed

10. Toldi G, Stenczer Bz, Molvarec A, Takáts Z, Beko G, Rigó J, et al. Hepcidin concentrations and iron homeostasis in preeclampsia. Clin Chem Lab Med 2010;48:1423–6.10.1515/CCLM.2010.290Suche in Google Scholar PubMed

11. Gyarmati B, Szabó E, Szalay B, Czuczy N, Toldi G, Cseh Á, et al. Serum maternal hepcidin levels 3 days after delivery are higher compared to those measured at parturition. J Obstet Gynaecol Res 2011;37:1620–4.10.1111/j.1447-0756.2011.01586.xSuche in Google Scholar PubMed

12. Finkenstedt A, Widschwendter A, Brasse-Lagnel CG, Theurl I, Hubalek M, Dieplinger H, et al. Hepcidin is correlated to soluble hemojuvelin but not to increased GDF15 during pregnancy. Blood Cells Mol Dis 2012;48:233–7.10.1016/j.bcmd.2012.02.001Suche in Google Scholar PubMed

13. van Santen S, van Dongen-Lases EC, de Vegt F, Laarakkers CM, van Riel PL, van Ede AE, et al. Hepcidin and hemoglobin content parameters in the diagnosis of iron deficiency in rheumatoid arthritis patients with anemia. Arthritis Rheum 2011;63: 3672–80.10.1002/art.30623Suche in Google Scholar

14. Punnonen K, Irjala K, Rajamaki A. Serum transferrin receptor and its ratio to serum ferritin in the diagnosis of iron deficiency. Blood 1997;89:1052–7.10.1182/blood.V89.3.1052Suche in Google Scholar

15. Rasmussen S, Bergsj P, Jacobsen G, Haram K, Bakketeig LS. Haemoglobin and serum ferritin in pregnancy: a correlation with smoking and body mass index. Eur J Obstet Gynecol Reprod Biol 2005;123:27–34.10.1016/j.ejogrb.2005.02.012Suche in Google Scholar

16. Beguin Y. Soluble transferrin receptor for the evaluation of erythropoiesis and iron status. Clin Chim Acta 2003;329: 9–22.10.1016/S0009-8981(03)00005-6Suche in Google Scholar

17. Kroot JJ, Laarakkers CM, Geurts-Moespot AJ, Grebenchtchikov N, Pickkers P, van Ede AE, et al. Immunochemical and mass-spectrometry-based serum hepcidin assays for iron metabolism disorders. Clin Chem 2010;56:1570–9.10.1373/clinchem.2010.149187Suche in Google Scholar PubMed

18. Available at http://www.hepcidinanalysis.com/documents/Hepcidinanalysis_SerumandPlasma_2011.pdf. Accessed 19 June, 2012.Suche in Google Scholar

19. Galesloot TE, Vermeulen SH, Geurts-Moespot AJ, Klaver SM, Kroot JJ, van Tienoven D, et al. Serum hepcidin: reference ranges and biochemical correlates in the general population. Blood 2011;117:e218–25.10.1182/blood-2011-02-337907Suche in Google Scholar PubMed

20. Larsson A, Palm M, Hansson LO, Axelsson O. Reference values for clinical chemistry tests during normal pregnancy. Br J Obstet Gynecol 2008;115:874–81.10.1111/j.1471-0528.2008.01709.xSuche in Google Scholar PubMed

21. Choi JW, Im MW, Pai SH. Serum transferrin receptor concentrations during normal pregnancy. Clin Chem 2000;46:725–7.10.1093/clinchem/46.5.725Suche in Google Scholar

22. Milman N, Bergholt T, Byg KE, Eriksen L, Hvas AM. Reference intervals for haematological variables during normal pregnancy and postpartum in 434 healthy Danish women. Eur J Haematol 2007;79:39–46.10.1111/j.1600-0609.2007.00873.xSuche in Google Scholar PubMed

23. Mei Z, Cogswell ME, Looker AC, Pfeiffer CM, Cusick SE, Lacher DA, et al. Assessment of iron status in US pregnant women from the National Health and Nutrition Examination Survey (NHANES), 1999–2006. Am J Clin Nutr 2011;93:1312–20.10.3945/ajcn.110.007195Suche in Google Scholar PubMed

24. Ganz T. Hepcidin and iron regulation, 10 years later. Blood 2011;117:4425–33.10.1182/blood-2011-01-258467Suche in Google Scholar

25. Mor G, Cardenas I. The immune system in pregnancy: a unique complexity. Am J Reprod Immunol 2010;63:425–33.10.1111/j.1600-0897.2010.00836.xSuche in Google Scholar

26. Yang Q, Jian J, Katz S, Abramson SB, Huang X. 17beta-Estradiol inhibits iron hormone hepcidin through an estrogen responsive element half-site. Endocrinology 2012;153:3170–8.10.1210/en.2011-2045Suche in Google Scholar

27. Hou Y, Zhang S, Wang L, Li J, Qu G, He J, et al. Estrogen regulates iron homeostasis through governing hepatic hepcidin expression via an estrogen response element. Gene 2012;511:398–403.10.1016/j.gene.2012.09.060Suche in Google Scholar

28. Reveiz L, Gyte GM, Cuervo LG, Casasbuenas A. Treatments for iron-deficiency anaemia in pregnancy. Cochrane Database Syst Rev 2011(10):CD003094.10.1002/14651858.CD003094.pub3Suche in Google Scholar

29. Yip R. Significance of an abnormally low or high hemoglobin concentration during pregnancy: special consideration of iron nutrition. Am J Clin Nutr 2000;72:272S–9S.10.1093/ajcn/72.1.272SSuche in Google Scholar

30. Roe MA, Collings R, Dainty JR, Swinkels DW, Fairweather-Tait SJ. Plasma hepcidin concentrations significantly predict interindividual variation in iron absorption in healthy men. Am J Clin Nutr 2009;89:1088–91.10.3945/ajcn.2008.27297Suche in Google Scholar

31. Zimmermann MB, Troesch B, Biebinger R, Egli I, Zeder C, Hurrell RF. Plasma hepcidin is a modest predictor of dietary iron bioavailability in humans, whereas oral iron loading, measured by stable-isotope appearance curves, increases plasma hepcidin. Am J Clin Nutr 2009;90:1280–7.10.3945/ajcn.2009.28129Suche in Google Scholar

32. Gangopadhyay R, Karoshi M, Keith L. Anemia and pregnancy: a link to maternal chronic diseases. Int J Gynaecol Obstet 2011;115 S1:S11–5.10.1016/S0020-7292(11)60005-2Suche in Google Scholar

33. Northrop-Clewes CA. Interpreting indicators of iron status during an acute phase response-lessons from malaria and human immunodeficiency virus. Ann Clin Biochem 2008;45:18–32.10.1258/acb.2007.007167Suche in Google Scholar PubMed

Received: 2012-9-4
Accepted: 2012-11-4
Published Online: 2012-12-14
Published in Print: 2013-07-01

©2013 by Walter de Gruyter Berlin Boston

Artikel in diesem Heft

  1. Masthead
  2. Masthead
  3. Editorials
  4. Biomarkers in the treatment of cancer: opportunities and pitfalls
  5. Multicenter reference intervals studies: a promising perspective for the future?
  6. Hemolysis-resistant reagent: another part of the puzzle for preventing errors in laboratory testing
  7. Review
  8. Exhaled breath condensate: a comprehensive update
  9. Mini Review
  10. Psoriasis, a new challenge for laboratory medicine
  11. Opinion Paper
  12. CA 19-9: handle with care
  13. General Clinical Chemistry and Laboratory Medicine
  14. Performance evaluation of human cytokines profiles obtained by various multiplexed-based technologies underlines a need for standardization
  15. The iron regulatory hormone hepcidin is decreased in pregnancy: a prospective longitudinal study
  16. Red blood cell distribution width is a potential prognostic index for liver disease
  17. Development of a novel, hemolysis-resistant reagent for assessment of α-amylase in biological fluids
  18. Performance of cassette-based blood gas analyzers to monitor blood glucose and lactate levels in a surgical intensive care setting
  19. Reference Values and Biological Variations
  20. The Asian project for collaborative derivation of reference intervals: (1) strategy and major results of standardized analytes
  21. The Asian project for collaborative derivation of reference intervals: (2) results of non-standardized analytes and transference of reference intervals to the participating laboratories on the basis of cross-comparison of test results
  22. Cancer Diagnostics
  23. Study of an elevated carbohydrate antigen 19-9 concentration in a large health check-up cohort in China
  24. Glycoproteomic identification of potential glycoprotein biomarkers in ovarian cancer proximal fluids
  25. Comparison of serum calcitonin and procalcitonin in detecting medullary thyroid carcinoma among patients with thyroid nodules
  26. Serum HER-2 predicts response and resistance to trastuzumab treatment in breast cancer
  27. Elevated tumor markers in patients with pulmonary alveolar proteinosis
  28. Serum carcinoembryonic antigen is associated with non-alcoholic fatty liver disease in healthy Korean non-smokers
  29. Assessment of SOX17 DNA methylation in cell free DNA from patients with operable gastric cancer. Association with prognostic variables and survival
  30. Sensitivity of CA 15-3, CEA and serum HER2 in the early detection of recurrence of breast cancer
  31. Cardiovascular Diseases
  32. Association of nucleotide-binding oligomerization domain-like receptor 3 inflammasome and adverse clinical outcomes in patients with idiopathic dilated cardiomyopathy
  33. Diabetes
  34. α1-Microglobulin/albumin ratio may improve interpretation of albuminuria in statin-treated patients
  35. Infectious Diseases
  36. The role of procalcitonin and IL-6 in discriminating between septic and non-septic causes of ALI/ARDS: a prospective observational study
  37. Letters to the Editor
  38. Carryover does not affect results of Beckman Coulter highly-sensitive-AccuTnI assay on Access 2
  39. Adding calcium to EDTA plasma samples prior to analysis could solve the compatibility issue in commercially available ELISAs that are standardized for serum
  40. Interference of luteinizing hormone in the urinary point-of-care human chorionic gonadotropin test
  41. Standardize the serum albumin assay now: calibrate it to 60% of the serum total protein assay
  42. Interference of M-paraprotein in automated urea assays
  43. A case of mistaken diagnosis of heparin-induced thrombocytopenia due to pseudothrombocytopenia
  44. Delta check: a must in the management of hyponatremia
  45. A novel cost effective algorithm for antinuclear antibody (ANA) testing in an outpatient setting
Heruntergeladen am 3.10.2025 von https://www.degruyterbrill.com/document/doi/10.1515/cclm-2012-0576/html?lang=de
Button zum nach oben scrollen