Serum Hepcidin Level in Obese Children and Adolescents: It’s Association with Iron Deficiency Anemia

Background: Childhood obesity is a worldwide chronic public health problem. It was found that obesity is associated with iron deficiency and iron profile abnormalities, which appear to be caused by several factors such as decreased intake, insufficient bioavailability, and deficient intestinal iron uptake as well as iron release from stores because of an over expression of hepcidin.

Aim of the Work: Was to estimate serum hepcidin levels in obese children and adolescents and to evaluate its relation with iron deficiency anemia in these children.

Subjects and Methods: The current study included 50 patients recruited from the Nutrition Clinic of Pediatric Department at Tanta University Hospital, 25 of them were obese with iron deficiency anemia and the other 25 were obese without iron deficiency anemia and 25 healthy children and adolescents of matched age and sex enrolled as controls. All studied children were subjected to complete history taking, thorough clinical examination including anthropometric measures (Weight, height, Body mass index), assessment of pubertal status using Tanner criteria and laboratory investigations including: CBC, BUN, creatinine, ALT, AST, stool analysis, occult blood in stool, CRP, iron profile, Serum Hepcidin, abdominal ultrasound.

Results: There were significant differences between patients and control group as regard Weight, BMI and their z scores. Significantly lower levels of hemoglobin, serum ferritin, serum iron and transferrin saturation in obese children with IDA than obese children without IDA and controls and significantly higher levels of TIBC were found in obese children with IDA compared to obese children without IDA and controls. As regard CRP it was significantly higher in obese children than controls. Serum hepcidin was significantly higher in obese children than controls but there is no significant difference between obese children with IDA and obese children without IDA. Significant positive correlation between Serum hepcidin levels and BMI in obese children was found. Conclusion: Serum hepcidin level was significantly higher in obese children and adolescents in comparison with healthy lean control with no significant difference between obese children with IDA and obese children without IDA. So, estimation of serum hepcidin level is not diagnostic but it may be beneficial in screening of iron deficiency anemia in pediatric obese individuals. Further studies with larger sample size are needed to verify these findings.