Plasma Concentrations of Hepcidin in Anemic Zimbabwean Infants.

<h4>Objective</h4>Anemia in infancy is a global public health problem. We evaluated the relative contributions of iron deficiency and inflammation to infant anemia.<h4>Methods</h4>We measured plasma hepcidin, ferritin, soluble transferrin receptor (sTfR), alpha-1-acid glycopr...

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Main Authors: Tatenda G Mupfudze, Rebecca J Stoltzfus, Sandra Rukobo, Lawrence H Moulton, Jean H Humphrey, Andrew J Prendergast, SHINE Trial Team, Andrew D Jones, Amee Manges, Goldberg Mangwadu, John A Maluccio, Mduduzi N N Mbuya, Robert Ntozini, James M Tielsch
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2015-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0135227&type=printable
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author Tatenda G Mupfudze
Rebecca J Stoltzfus
Sandra Rukobo
Lawrence H Moulton
Jean H Humphrey
Andrew J Prendergast
SHINE Trial Team
Andrew D Jones
Amee Manges
Goldberg Mangwadu
John A Maluccio
Mduduzi N N Mbuya
Robert Ntozini
James M Tielsch
author_facet Tatenda G Mupfudze
Rebecca J Stoltzfus
Sandra Rukobo
Lawrence H Moulton
Jean H Humphrey
Andrew J Prendergast
SHINE Trial Team
Andrew D Jones
Amee Manges
Goldberg Mangwadu
John A Maluccio
Mduduzi N N Mbuya
Robert Ntozini
James M Tielsch
author_sort Tatenda G Mupfudze
collection DOAJ
description <h4>Objective</h4>Anemia in infancy is a global public health problem. We evaluated the relative contributions of iron deficiency and inflammation to infant anemia.<h4>Methods</h4>We measured plasma hepcidin, ferritin, soluble transferrin receptor (sTfR), alpha-1-acid glycoprotein and C-reactive protein (CRP) by ELISA on archived plasma from 289 HIV-unexposed anemic or non-anemic Zimbabwean infants at ages 3 mo, 6 mo and 12 mo. Among anemic infants, we determined the proportion with iron-deficiency anemia (IDA) and anemia of inflammation (AI). We undertook regression analyses of plasma hepcidin and anemia status, adjusting for sex, age and birthweight.<h4>Results</h4>Anemic infants at 3 mo were more stunted and had higher CRP (median 0.45 vs 0.21 mg/L; P = 0.037) and hepcidin (median 14.7 vs 9.7 ng/mL; P = 0.022) than non-anemic infants, but similar levels of ferritin and sTfR; 11% infants had IDA and 15% had AI. Anemic infants at 6 mo had higher hepcidin (median 7.9 vs 4.5 ng/mL; P = 0.016) and CRP (median 2.33 vs 0.32 mg/L; P<0.001), but lower ferritin (median 13.2 vs 25.1 μg/L; P<0.001) than non-anemic infants; 56% infants had IDA and 12% had AI. Anemic infants at 12 mo had lower ferritin (median 3.2 vs 22.2 μg/L; P<0.001) and hepcidin (median 0.9 vs 1.9 ng/mL; P = 0.019), but similar CRP levels; 48% infants had IDA and 8% had AI. Comparing anemic with non-anemic infants, plasma hepcidin was 568% higher, 405% higher and 64% lower at 3 mo, 6 mo and 12 mo, respectively, after adjusting for sex and birthweight (all p<0.01). Plasma hepcidin declined significantly with age among anemic but not non-anemic infants. Girls had 61% higher hepcidin than boys, after adjusting for age, anemia and birthweight (p<0.001).<h4>Conclusion</h4>Anemia is driven partly by inflammation early in infancy, and by iron deficiency later in infancy, with plasma hepcidin concentrations reflecting the relative contribution of each. However, there is need to better characterize the drivers of hepcidin during infancy in developing countries.
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spelling doaj-art-cbefa2bd5113426983b919b0534c828b2025-08-20T02:34:09ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01108e013522710.1371/journal.pone.0135227Plasma Concentrations of Hepcidin in Anemic Zimbabwean Infants.Tatenda G MupfudzeRebecca J StoltzfusSandra RukoboLawrence H MoultonJean H HumphreyAndrew J PrendergastSHINE Trial TeamAndrew D JonesAmee MangesGoldberg MangwaduJohn A MaluccioMduduzi N N MbuyaRobert NtoziniJames M Tielsch<h4>Objective</h4>Anemia in infancy is a global public health problem. We evaluated the relative contributions of iron deficiency and inflammation to infant anemia.<h4>Methods</h4>We measured plasma hepcidin, ferritin, soluble transferrin receptor (sTfR), alpha-1-acid glycoprotein and C-reactive protein (CRP) by ELISA on archived plasma from 289 HIV-unexposed anemic or non-anemic Zimbabwean infants at ages 3 mo, 6 mo and 12 mo. Among anemic infants, we determined the proportion with iron-deficiency anemia (IDA) and anemia of inflammation (AI). We undertook regression analyses of plasma hepcidin and anemia status, adjusting for sex, age and birthweight.<h4>Results</h4>Anemic infants at 3 mo were more stunted and had higher CRP (median 0.45 vs 0.21 mg/L; P = 0.037) and hepcidin (median 14.7 vs 9.7 ng/mL; P = 0.022) than non-anemic infants, but similar levels of ferritin and sTfR; 11% infants had IDA and 15% had AI. Anemic infants at 6 mo had higher hepcidin (median 7.9 vs 4.5 ng/mL; P = 0.016) and CRP (median 2.33 vs 0.32 mg/L; P<0.001), but lower ferritin (median 13.2 vs 25.1 μg/L; P<0.001) than non-anemic infants; 56% infants had IDA and 12% had AI. Anemic infants at 12 mo had lower ferritin (median 3.2 vs 22.2 μg/L; P<0.001) and hepcidin (median 0.9 vs 1.9 ng/mL; P = 0.019), but similar CRP levels; 48% infants had IDA and 8% had AI. Comparing anemic with non-anemic infants, plasma hepcidin was 568% higher, 405% higher and 64% lower at 3 mo, 6 mo and 12 mo, respectively, after adjusting for sex and birthweight (all p<0.01). Plasma hepcidin declined significantly with age among anemic but not non-anemic infants. Girls had 61% higher hepcidin than boys, after adjusting for age, anemia and birthweight (p<0.001).<h4>Conclusion</h4>Anemia is driven partly by inflammation early in infancy, and by iron deficiency later in infancy, with plasma hepcidin concentrations reflecting the relative contribution of each. However, there is need to better characterize the drivers of hepcidin during infancy in developing countries.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0135227&type=printable
spellingShingle Tatenda G Mupfudze
Rebecca J Stoltzfus
Sandra Rukobo
Lawrence H Moulton
Jean H Humphrey
Andrew J Prendergast
SHINE Trial Team
Andrew D Jones
Amee Manges
Goldberg Mangwadu
John A Maluccio
Mduduzi N N Mbuya
Robert Ntozini
James M Tielsch
Plasma Concentrations of Hepcidin in Anemic Zimbabwean Infants.
PLoS ONE
title Plasma Concentrations of Hepcidin in Anemic Zimbabwean Infants.
title_full Plasma Concentrations of Hepcidin in Anemic Zimbabwean Infants.
title_fullStr Plasma Concentrations of Hepcidin in Anemic Zimbabwean Infants.
title_full_unstemmed Plasma Concentrations of Hepcidin in Anemic Zimbabwean Infants.
title_short Plasma Concentrations of Hepcidin in Anemic Zimbabwean Infants.
title_sort plasma concentrations of hepcidin in anemic zimbabwean infants
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0135227&type=printable
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