Serum prohepcidin and other iron metabolism parameters in elderly patients with anemia of chronic disease and with iron deficiency anemia

INTRODUCTION The diagnosis of iron deficiency anemia (IDA) in the context of the anemia of chronic disease (ACD) in elderly patients is often difficult due to the existence of many disorders. Recent studies have shown that hepcidin measurement (combined with the existing diagnostic methods) may possibly help in the differential diagnosis of IDA and ACD. 
OBJECTIVES The aim of the study was to evaluate the differential diagnostic value of serum prohepcidin in elderly patients with IDA and ACD. 
PATIENTS AND METHODS The study included 65 individuals aged 65 years or more: 26 patients with ACD, 13 patients with IDA, and 26 age‑matched controls. Prohepcidin, ferritin, soluble transferrin receptor, erythropoietin, and interleukin 6 (IL‑6) were measured using the commercially available enzyme‑linked immunosorbent assay kits. Complete blood count, total iron‑binding capacity (TIBC), and iron, transferrin, and C‑reactive protein (CRP) levels were assayed using the standard laboratory methods. 
RESULTS Prohepcidin concentrations were similar in patients with ACD (196.59 ng/ml) compared with those with IDA (230.16 ng/ml) (P = 0.35). Patients with ACD had significantly lower levels of TIBC compared with those with IDA (P <0.0001). Serum ferritin concentration in patients with ACD was almost 20‑fold higher compared with those observed in patients with IDA (P <0.0001). CRP and IL‑6 concentrations in patients with ACD were significantly higher compared with those with IDA.
CONCLUSIONS The results of the study indicate that serum prohepcidin has limited value in the differential diagnosis of IDA and ACD in elderly patients.