The association between serum hepcidin and hepatic fibrosis levels in patients with chronic hepatitis B

Introduction and aim: Iron metabolism disorders have been defined in progression of chronic hepatic diseases at various levels. It has been reported that hepcidin hormone, which is produced in liver and is the main regulator of iron metabolism, has an important role in the progressive hepatic disease. We aimed to evaluate the correlation between serum hepcidin level as well as hepatic fibrosis score, which has been revealed by liver biopsy, and iron deposition in liver in patients with chronic hepatitis B (CHB). Method: A total of 149 cases (126 CHB, and 23 healthy controls) were enrolled in the study. Percutaneous liver biopsy was performed in all CHB patients. Fibrosis, HAI, and liver iron amount were determined in biopsy samples. Serum hepcidin levels, liver function tests, and serum iron parameters of all patients were measured. CHB patients were compared in all parameters within the group between subgroups as well as in biochemical measurements with the control group. Results: Serum hepcidin level was defined markedly lower in CHB patients than the control group (p<0.001). Increased iron deposition was detected in the liver of 26 CHB (20.6%) patients. Patients were divided into a total of 6 subgroups according to fibrosis stages. There was a significant correlation with negative direction between hepcidin level, fibrosis stage and HAI (respective p values 0.007 and 0.05). No statistically significant difference was detected between mean levels of hepcidin and fibrosis stage. Number of patients was increased by forming 3 subgroups according to fibrosis stage, like mild, moderate, and severe. Groups were compared within themselves. Statistically significant difference was defined between fibrosis stage and hepcidin level (p=0.05). Conclusion: Presence of negative correlation between hepcidin level and fibrosis may support that hepcidin has a role in fibrosis pathogenesis. Large sized studies are required to be performed to define hepcidin as an indicator of fibrosis. Key words: Chronic Hepatitis B, Fibrosis, Hepcidin, Ferritin.