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Cord Blood Hepcidin: Cross-Sectional Correlates and Associations with Anemia, Malaria, and Mortality in a Tanzanian Birth Cohort Study.

Accepted version
Peer-reviewed

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Type

Article

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Authors

Brickley, Elizabeth B 
Spottiswoode, Natasha 
Kabyemela, Edward 
Morrison, Robert 
Kurtis, Jonathan D 

Abstract

Hepcidin, the master regulator of bioavailable iron, is a key mediator of anemia and also plays a central role in host defense against infection. We hypothesized that measuring hepcidin levels in cord blood could provide an early indication of interindividual differences in iron regulation with quantifiable implications for anemia, malaria, and mortality-related risk. Hepcidin concentrations were measured in cord plasma from a birth cohort (N = 710), which was followed for up to 4 years in a region of perennial malaria transmission in Muheza, Tanzania (2002-2006). At the time of delivery, cord hepcidin levels were correlated with inflammatory mediators, iron markers, and maternal health conditions. Hepcidin levels were 30% (95% confidence interval [CI]: 12%, 44%) lower in children born to anemic mothers and 48% (95% CI: 11%, 97%) higher in placental malaria-exposed children. Relative to children in the lowest third, children in the highest third of cord hepcidin had on average 2.5 g/L (95% CI: 0.1, 4.8) lower hemoglobin levels over the duration of follow-up, increased risk of anemia and severe anemia (adjusted hazard ratio [HR] [95% CI]: 1.18 [1.03, 1.36] and 1.34 [1.08, 1.66], respectively), and decreased risk of malaria and all-cause mortality (adjusted HR [95% CI]: 0.78 [0.67, 0.91] and 0.34 [0.14, 0.84], respectively). Although longitudinal measurements of hepcidin and iron stores are required to strengthen causal inference, these results suggest that hepcidin may have utility as a biomarker indicating children's susceptibility to anemia and infection in early life.

Description

Keywords

Anemia, Biomarkers, Child, Preschool, Cohort Studies, Cross-Sectional Studies, Female, Fetal Blood, Hepcidins, Humans, Infant, Iron, Malaria, Male, Risk, Tanzania

Journal Title

Am J Trop Med Hyg

Conference Name

Journal ISSN

0002-9637
1476-1645

Volume Title

95

Publisher

American Society of Tropical Medicine and Hygiene
Sponsorship
Medical Research Council (MR/L003120/1)
Medical Research Council (G0800270)
British Heart Foundation (None)
British Heart Foundation (None)
Medical Research Council (G0800270/1)