Circulating Hepcidin in the Crossroads of Anemia and Inflammation Associated with Rheumatoid Arthritis

OBJECTIVE: To investigate the role of circulating hepcidin, which is a homeostatic regulator of iron metabolism and a mediator of inflammation, in anemia associated with rheumatoid arthritis. METHODS: Forty patients with rheumatoid arthritis (19 with anemia and 21 without anemia), 12 patients with iron deficiency anemia and 14 healthy adults were studied. Serum hepcidin levels were analyzed with hepcidin prohormone solid phase enzyme-linked immunosorbent assay. RESULTS: The mean serum hepcidin levels were significantly higher in patients with rheumatoid arthritis with anemia compared to healthy adults and those with iron deficiency anemia. The active rheumatoid arthritis group had significantly higher mean serum hepcidin levels than the inactive rheumatoid arthritis group. In the rheumatoid arthritis group, serum hepcidin levels were positively correlated with disease activity, but inversely correlated with hemoglobin levels. The serum hepcidin level was found to be a significant predictor for hemoglobin level. CONCLUSION: Serum hepcidin levels are closely associated with disease activity in rheumatoid arthritis patients and might play a role in the pathobiology of chronic disease anemia associated with rheumatoid arthritis.