Effects of iron supplementation on serum hepcidin and serum erythropoietin in low-birth-weight infants

Staffan Berglund, Bo Lönnerdal, Björn Westrup, Magnus Domellöf

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background: The iron-regulatory hormone hepcidin has not been studied in infants, who experience large physiologic changes in iron status. Objective: The objective was to study hepcidin and erythropoietin and their correlation with iron status in iron-replete and irondeficient low-birth-weight (LBW) infants - a group at particular risk of iron deficiency (ID). Design: We randomly assigned 285 otherwise healthy LBW infants to receive, from 6 wk to 6 mo of age, 3 doses of iron supplements: 0 (placebo), 1, or 2 mg/kg daily. Hepcidin, erythropoietin, hemoglobin, and variables of iron status were analyzed. Results: Serum hepcidin did not change over time in the placebo group, despite a rapid decrease in serum ferritin. In iron-supplemented infants, hepcidin increased significantly, reaching a mean (±SD) concentration of 19.2 ± 2.5 ng/mL in the 2-mg/kg group compared with 13.0 ± 2.6 ng/mL in the placebo group at age 6 mo (P < 0.001). The difference was even larger between irondeficient and iron-replete infants. Hepcidin was independently positively correlated with ferritin at all ages and was negatively correlated with the transferrin receptor concentration at age 6 wk and with transferrin at age 6 mo. Erythropoietin was initially similar between groups but decreased significantly in iron-supplemented infants. In addition to being negatively correlated with hemoglobin, it was also independently negatively correlated with indicators of iron status. Conclusions: Hepcidin is closely associated with iron status and may be a useful indicator of iron stores and ID in infants. Erythropoietin is negatively correlated with iron status, which suggests a feedback mechanism that needs further study. This trial is registered at clinicaltrials.gov as NCT00558454.

Original languageEnglish (US)
Pages (from-to)1553-1561
Number of pages9
JournalAmerican Journal of Clinical Nutrition
Volume94
Issue number6
DOIs
StatePublished - Dec 1 2011

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Hepcidins
Low Birth Weight Infant
Erythropoietin
Iron
Serum
Placebos
Ferritins
Hemoglobins
Transferrin Receptors
Transferrin

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Effects of iron supplementation on serum hepcidin and serum erythropoietin in low-birth-weight infants. / Berglund, Staffan; Lönnerdal, Bo; Westrup, Björn; Domellöf, Magnus.

In: American Journal of Clinical Nutrition, Vol. 94, No. 6, 01.12.2011, p. 1553-1561.

Research output: Contribution to journalArticle

Berglund, Staffan ; Lönnerdal, Bo ; Westrup, Björn ; Domellöf, Magnus. / Effects of iron supplementation on serum hepcidin and serum erythropoietin in low-birth-weight infants. In: American Journal of Clinical Nutrition. 2011 ; Vol. 94, No. 6. pp. 1553-1561.
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AB - Background: The iron-regulatory hormone hepcidin has not been studied in infants, who experience large physiologic changes in iron status. Objective: The objective was to study hepcidin and erythropoietin and their correlation with iron status in iron-replete and irondeficient low-birth-weight (LBW) infants - a group at particular risk of iron deficiency (ID). Design: We randomly assigned 285 otherwise healthy LBW infants to receive, from 6 wk to 6 mo of age, 3 doses of iron supplements: 0 (placebo), 1, or 2 mg/kg daily. Hepcidin, erythropoietin, hemoglobin, and variables of iron status were analyzed. Results: Serum hepcidin did not change over time in the placebo group, despite a rapid decrease in serum ferritin. In iron-supplemented infants, hepcidin increased significantly, reaching a mean (±SD) concentration of 19.2 ± 2.5 ng/mL in the 2-mg/kg group compared with 13.0 ± 2.6 ng/mL in the placebo group at age 6 mo (P < 0.001). The difference was even larger between irondeficient and iron-replete infants. Hepcidin was independently positively correlated with ferritin at all ages and was negatively correlated with the transferrin receptor concentration at age 6 wk and with transferrin at age 6 mo. Erythropoietin was initially similar between groups but decreased significantly in iron-supplemented infants. In addition to being negatively correlated with hemoglobin, it was also independently negatively correlated with indicators of iron status. Conclusions: Hepcidin is closely associated with iron status and may be a useful indicator of iron stores and ID in infants. Erythropoietin is negatively correlated with iron status, which suggests a feedback mechanism that needs further study. This trial is registered at clinicaltrials.gov as NCT00558454.

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