Analysis of Serum Hepcidin Levels in Children with Iron Deficiency

Abstract

Introduction: Iron deficiency, with or without anemia, remains one of the most prevalent nutritional deficiencies among children worldwide, including Indonesia. Hepcidin, a peptide hormone produced by the liver, serves as the principal regulator of systemic iron homeostasis. Its levels decrease during iron deficiency, rendering it a potential biomarker for early detection before anemia develops. However, limited research has examined serum hepcidin in Indonesian children with varying iron statuses.

Objective: To analyze serum hepcidin levels among children with normal iron status, stage I iron deficiency, stage II iron deficiency, and iron deficiency anemia (IDA).

Methods: A cross-sectional study was conducted from February to April 2025 involving children aged 1–18 years residing in 15 orphanages in Makassar City. Subjects were classified into four groups based on hematological and biochemical parameters (Hb, MCV, MCH, reticulocytes, and ferritin): normal, stage I ID, stage II ID, and IDA. Serum hepcidin concentrations were quantified using the Human Hepcidin ELISA kit (BT-Assay E1019Hu). Statistical analysis employed ANOVA, Kruskal–Wallis, and Mann–Whitney tests with a significance level of p < 0.05.

Results: A total of 117 children participated in the study (normal = 30; stage I ID = 30; stage II ID = 30; IDA = 27). Significant differences were observed across iron status groups for Hb, MCV, MCH, and ferritin (p < 0.05). Serum hepcidin levels declined progressively with worsening iron deficiency, reaching their lowest levels in the IDA group (p = 0.003). Hepcidin levels were not significantly different between normal, stage I ID, and stage II ID groups, but were markedly reduced in IDA.

Conclusion: Serum hepcidin levels significantly decrease in children with IDA, confirming its potential as a sensitive biomarker for detecting iron deficiency before anemia onset. Incorporating hepcidin measurement into standard iron status assessments may enhance the accuracy of early diagnosis and improve preventive interventions.