| Object:This study aimed at investigating serum hepcidin, serum growth differentiate factor-15(GDF 15) levels and iron metabolism values in patients with thalassemia and to study the correlation between these values.Methods:We study 111 patients with HbH,81 patients with β-TI,94 patents with β-TM and 101 healthy vounlteers.All sample from subjects were determined by ELISA kit to compare hepcidin,GDF15 concentration and their liver iron concentration as well as Cardiac T2 values performed by MRI.Results:1 The median hepcidin in healthy vounlteer was 115.7ng/ml (range 8.2-190.5),the median hepcidin of HbH, β-TI, β-TM groups were 24.4ng/ml, 9.5ng/ml,33.2ng/ml respectively. The median hepcidin of three thalassemia groups was significant lower than healthy vounlteer group, the difference reach the statistic meanings (P<0.05).The median hepcidin of β-TI group was significant lower than HbH, β-TM groups and the difference both reach the statistic meaning (P<0.05). However, there was no difference between HbH and β-TM groups (P>0.05) There was no statistic difference in hepcidin between deletion HbH group and non deletion HbH group(P>0.05)。 There was no statistic difference in hepcidin between splenctomied HbH group and non splenctomied HbH group(P>0.05)。 There was no statistic difference in hepcidin between β-TI heter HbE group andβ-TI non heter HbE group(P>0.05).The level of hepcidin in splenctomied P-TI group was lower than non-β splenctomied β-TI group(P<0.05)。2 The median GDF15 in healthy vounlteer was 141.6pg/ml,the median GDF 15 of HbH, β-TI, β-TM groups were 1190 pg/ml、10731 pg/ml、 10467 pg/ml respectively.The median GDF 15 of three thalassemia groups was significant higher than healthy vounlteer group, the difference reach the statistic meanings (P<0.05).The median GDF 15 of HbH group was significant lower than β-TI, β-TM groups and the difference both reach the statistic meaning (P <0.05). However, there was no difference between β-TI and β-TM groups (P >0.05). The level of GDF 15 in deletion HbH group was lower than non-deletion HbH group and the difference reach statistic meaning. (P <0.05).There was no difference between splenctomied HbH group and non-splenctomied HbH group(P>0.05).There was no difference betweenβ-TI heter HbE group andβ-TI non heter HbE group(P>0.05). There was no no difference betweenβ-TI splenctomied group andp-TI non splenctomied group(P>0.05).3 The median of serum ferritin (SF) of healthy control was 124.3ng/ml, the median of serum ferritin of HbH, β-TI, β-TM groups were 553ng/ml、 1453ng/ml、2975ng/ml respectively.The median SF of three thalassemia groups was significant higher than healthy vounlteer group, the difference reach the statistic meanings (P<0.05).The median SF of β-TM group was significant higher than β-TI, HbH groups and the difference both reach the statistic meaning (P<0.05). The median SF ofβ-TI group was significant higher than HbH group and the difference reach the statistic meaning (P<0.05)4 The median of liver iron concentration (LIC) of HbH, β-TI, β-TM groups were 7.2mg/g、14.8mg/g、42.4mg/g respectively.The median LIC of three thalassemia groups was significant higher than the upper limitation of reference, the difference reach the statistic meanings (P＜0.05).The median LIC of β-TM group was significant higher than P-TI, HbH groups and the difference both reach the statistic meaning (P<0.05). The medianLIC of β-TI group was significant higher than HbH group and the difference reach the statistic meaning (P＜0.05)5 The median of Cardiac T2 value of HbH, β-TI, β-TM groups were 30.25ms、33.1 ms、17.0ms respectively.The median Cardiac T2 value of p-TM group was significant lower than HbH and β-TI groups and the difference both reach the statistic meaning (P<0.05).However, there was no difference betweenβ-TI and HbH group (P>0.05)6 In healthy control, hepcidin was positive correlated to SF,GDF15 (r=0.341, P=0.001; r=0.275, P=0.005) but not to age,gender,Hb. In patients with HbH, hepcidin was positive correlated to age,SF,LIC (r=0.216, P=0.022; r=0.344, P=0.001; r=0.319, P=0.016) and negative correlated to GDF15 (r=-0.201, P=0.033).In patients with β-TI,hepcidin was only negative correlated to GDF 15 (r=-0.245, P=0.028) but not to age, gender, Hb,SF,LIC etc.In patients with P-TM,hepcidin was negative to age, GDF 15 (r=-0.251, P =0.015; r=-0.6, P=0.001) but not to LIC、CardiacT2.7 In healthy control, GDF 15 was positive correlated to age and SF (r=0.195, P=0.05; r=0.396, P=0.001) but not related to Hb. In patients with HbH,GDF15 was positive correlated to SF,LIC (r=0.314, P=0.001; r=0.359, P=0.009)and negative correlated to Hb (r=-0.34,P=0.001)but not correlated to age and Caridac T2.In patients with β-TI,GDF15 was positive correlated to SF and LIC (r=0.275, P=0.017; r=0.339, P=0.033) and negative correlated to Hb (r=-0.24, P=0.049) but not to age and Caridac T2.In patients with β-TM,GDF15 was positive to age negative to age (r=0.278, P=0.007) but negative to Hb ((r=-0.66, P=0.001)) but not to SF、LIC、CardiacT2.Conclusion:1 The serum hepcidin of patients with thalassemia major and intermedia were significantly decreased when compared with healthy control.and the serum GDF15 of patients with thalassemia major and intermedia were significant higher than healthy control.2 The iron overload in liver and heart in patients with β-TM were worse than the patients with HbH and β-TI.The iron overload in liver in patients with TI were worse than the patients with HbH.3 The patient with β-TI should be taken into more attention and management out of their lowest of serum hepcidin and moderate iron overload. |
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