Correlation Research Of Serum Hepcidin Levels And Neurologic Deficit Of Patients With Intracerebral Hemorrhage

Background and ObjectiveIntracerebral hemorrhage(ICH) results from the rupture of weakened blood vessels and causes bleeding into the surrounding brain parenchyma, account for 20 ~30% of the cerebrovascular disease, and characterized by high morbidity and mortality and high disability rate. About 88% survival ICH patients leave over obvious disability, which poses a serious burden to the society and family. Mounting evidence shows that iron deposited in the perihematoma is implicated in ICH-induced secondary brain damage. Thus, reducing perihematoma-deposited iron plays a significant role in the treatment of ICH. However, the mechanisms of brain iron metabolism are still not completely clear. Thus, only elucidating the detailed mechanisms of brain iron metabolism after ICH can effectively target the reducing iron treatment, and providing a new method for ICH treatment.Researches showed that serum ferritin is positively correlated with neurologic deficit of patients with ICH. Hepcidin is one of the most important iron-regulated polypeptide hormone, and plays an important role in maintaining the iron metabolic balance of organism and cells by binding to its receptor, ferroportin, the sole known iron exporter that is present on the surface of cells, then ferroportin is internalized and degraded, leading to accumulated cellular iron causing toxic effect. Hepcidin is regulated by the inflammation and iron levels etc. However, the change features of hepcidin after ICH and its correlation with neurologic deficit scores(NDS) are still not clear. Thus, we investigated and analysed the association between serum hepcidin and NDS of patients with ICH using their serum samples.Methods and Results81 consecutive patients with primary ICH admitted to our hospital within 12 hours from symptom ictus(mean: 5.1 hours) was generated from May 2013 to June 2014. Their clinical data were collected consecutively. Serum samples were obtained on consecutive days to detect the levels of hepcidin, iron, interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α). The National Institutes of Health Stroke Scale score(NIHSS) was measured at admission and on days 7 and 30, and the modified Rankin Scale(mRS) score was evaluated at 3 months after ICH. According to the mRS scores, we divided the patients into good outcome group(mRS ≤ 2) and poor outcome group(mRS > 2). We found that higher serum hepcidin levels were detected in patients with poor outcome(P < 0.001), and the mRS score increased by a mean of 1.135 points(95% CI, 1.021~1.247, P < 0.001) for every serum hepcidin quartie after adjusting for other prognostic variables. Additionally, the Pearson correlation analysis showed that serum hepcidin was negatively correlated with serum iron(r =-0.5301, P < 0.001), and a significantly lower concentration of serum iron was found in patients with poor outcome(P = 0.007).ConclusionsThese results suggest that serum hepcidin is negatively correlated with serum iron, and positively correlated with the outcome of patients with ICH, and serum hepcidin may be a biological marker for outcome prediction. In addition, this research may lay a foundation for the following research of the role of hepcidin in the brain iron metabolism after ICH.