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Hepcidin is an interleukin-6 induced peptide hormone involved in iron metabolism and inflammation.1 Serum hepcidin level may distinguish anaemia due to chronic inflammation and/or iron deficiency in rheumatoid arthritis (RA) patients.2 Furthermore, some studies have suggested that serum hepcidin could reflect disease activity raising its measurement as a new surrogate biomarker of RA.3–6 These studies have several drawbacks (unreliable pro-hormone quantification, small number of patients).7 ,8 Therefore, we assessed the serum level of the mature form of hepcidin by ELISA (Bachem, St Helens, Merseyside, UK) in 791 individuals from the French cohort of early arthritis (ESPOIR) including 632 patients with RA fulfilling the American College of Rheumatology (ACR) - European League Against Rheumatism (EULAR) criteria at inclusion and 159 with undifferentiated arthritis in order to address whether hepcidin accurately reflects RA features, disease activity or radiographic disease progression.9 ,10
Beyond expected differences between RA and undifferentiated arthritis, serum hepcidin level was higher in RA (table 1). Hepcidin level was positively correlated with disease activity score in 28 joints (DAS28)-erythrocyte sedimentation rate at inclusion. However, the only variable used in calculating DAS28 that was correlated …
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