Background The leading pathogenetic factor in development of the anemia of chronic disease is disturbance of the exchange of iron. Pro-hepcidin, a recently indentified peptide, acts as a central regulating the uptake of dietary iron and its mobilization from macrophages and hepatic stores. It is considered as a mediator of anemia of inflammation.
Objectives to estimate interrelation of level Pro-hepcidin with indicators of activity of inflammatory process and hemoglobin level (Hb) at patients with (RA).
Methods It has been included 76 patients with RA average- 46,3 years, duration of desease 60[17;96] month, activity on DAS 28- 6,15±1,35. The anemia has been diagnosed for 47 patients by criteria the CART (Hb 104,3±21,4 g/l. Concentration of serum pro-hepcidin in blood defined an immunoenzymatic method.Serum iron defined with the help a method with use of an ascorbate and ferrosin as a reagent, Serum firms Roche Integra Gen.2 Ferritin defined with the help immunology, a method based on agglutination of a ferritin with latex particles, the covered antibodies to a ferritin.
Results It has been included 76 patients with RA (65 women and 11 men), compare age - 46,3 years, duration of disease 60 [17; 96] month, activity on DAS28 –(6,15±1,35 points).The anemia has been diagnosed for 47 patients by criteria the CART (Hb 104,3±21,4 g/l).Patients with anemia (N=47) and with out (N=29) were comparable (p>0,05) on age 45,5±14,3 and 48,9±14,3 years, duration of illness 60 [36; 96] and 60 [17; 84] month, DAS28-6,4±1,7 and 5,9±1,0 levels of CRP (44,5[20,3; 110,2] and 37,8[12,7; 47,2] mg/l) ESR (46,5±21,3 and 41,0±20,3 mm/h). Serumal iron was much more low at patients with the anemia (9,5±5,6 and 18,5±7,7 mkmol/l, p=0,01).The Pro-hepcidin level was higher at patients with RA and with the anemia, than with out it (120,3±56,1comparison with 90,3±37,9ng/ml, p=0,04).In group with the anemia direct correlation between hemoglobin level, Pro-hepcidin and (r=0,45; p=0,01) in the ferritin (r=0,52; p=0,002). Has been taped Pro-hepcidin also correlated with serumal iron, levels DAS28.
In group of patients with normal concentration of hemoglobin Pro-hepcidin positively correlated with indicators of activity of inflammatory process CRP, ESR DAS28 (rCPR=0,51, p=0,03; rESR=0,62, p=0,01; rDAS28=0,4; p=0,025) interrelations levels of hemoglobin and serum iron were not.
Conclusions At patients with Rheumatoid arthritis (RA) rising of level serum Pro-hepcidin in blood is bound not only to activity of inflammatory process, but also is independent predictor of developments ACD.
Disclosure of Interest None Declared