Comparison of hepcidin levels across chronic inflammatory state disease: type 2 diabetes mellitus, cancer, chronic kidney disease, HIV, and tuberculosis

INTRODUCTION: Hepcidin plays an important role in the impairment of iron metabolism in diseases associated with chronic inflammation. Our study aimed to compare hepcidin levels in patients with type 2 diabetes mellitus (T2DM), cancer, chronic kidney disease (CKD), Human Immunodeficiency Virus (HIV) infection, and tuberculosis (TB).
METHODS: This was an observational study with an analytical cross-sectional design conducted from November 2020 to December 2021. The subjects included in this study were patients aged 18 years or older who were diagnosed with T2DM; solid and hematologic cancers that did not receive chemotherapy, radiation, or surgery; patients with CKD stage 3 or higher with or without dialysis therapy; HIV-infected patients; and patients diagnosed with pulmonary and extrapulmonary tuberculosis. A total of 407 participants were included in this study. Comparison of hepcidin levels across different disease populations was analyzed with the Kruskal-Wallis test followed by Mann-Whitney post-hoc analysis.
RESULTS: The median level of hepcidin that we obtained in all subjects studied was 40.2 (minimum-maximum: 1.32-283.41) ng/ml. We found significant differences in hepcidin levels in each disease category. The cancer population had the highest hepcidin levels, followed by the HIV, diabetes, tuberculosis, and CKD populations.
DISCUSSION AND CONCLUSION: Differences in hepcidin levels indicate differences in the degree of inflammation, reflecting the dysregulation of iron metabolism in T2DM, cancer, CKD, HIV infection, and tuberculosis.