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Study of Hepcidin Level in Samples of Iraqi Patients With Iron Overload and Iron Deficiency Disorders

Hepcidin, a regulator of iron recycling and absorption, is a small peptide created by the hepatocytes when there is an increase in body iron and inflammation. It is regarded as a master regulator for the metabolism of iron. Hepcidin decreases iron absorption from food by decreasing the transportation of iron across the enterocytes in the gut mucosa. Hepcidin decreases iron escape from macrophages, which are considered as the main site for storage of iron and decreases iron escape from the liver. 
  The aim of the study is to determine the properties of hepcidin as a diagnostic test of iron deficiency and to focus on its properties as a diagnostic test in iron overload. 
  Thirty-four patients with iron deficiency anemia (IDA) and thirty patients with beta - thalassemia major were collected randomly from the National center of Hematology and from thalassemia center in Al-Karama Hospital respectively. Together with thirty age and sex matched healthy volunteers were collected as a control.History was taken and physical examination was done. Blood samples were taken; hematological parameters were estimated for all three groups. 
  High hepcidin level was detected in 30 out of 34 patients with iron deficiency anemia with a mean range of (205.3 ng/ml). High hepcidin level is due to inflammatory conditions. In four patients with iron deficiency anemia, hepcidin levels were low and this is due to anemia and hypoxia. These stimulations decrease hepcidin production. In 30 patients with iron overload, hepcidin concentration was of low level with a mean range of (6.7 ng/ml) and this is due to stress erythropoiesis. 
  These results suggest that serum hepcidin in iron deficiency anemia patients is high in spite of that the patients were not receiving iron supplement while in iron overload (IOL) patients serum hepcidin level is low mainly because of stress erythropoiesis due to their poor management.