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Background: Rheumatoid arthritis (RA) is a chronic autoimmune disorder and anemia is a prevalent extraarticular manifestation in RA, affecting 30% to 70% of individuals. The complex aetiology of anemia in RA involves chronic inflammation, iron deficiency, and medication-related adverse effects. Hepcidin level is influenced by inflammation and anemia. There have been contrasting results in the studies thus far correlating serum hepcidin levels and disease activity in anemic RA patients. Therefore this study was undertaken. Objectives: To evaluate serum hepcidin levels in Rheumatoid Arthritis patients with anemia and study correlation between serum hepcidin levels and disease activity in those patients. Methods: This was a prospective, non-interventional, observational, cross-sectional study conducted from 1st January 2022 to 30th June 2023 at the Clinical Immunology and Rheumatology Division of the General Medicine Department at All India Institute of Medical Sciences, Rishikesh. Adult patients meeting the 2010 ACR/ EULAR criteria for RA and presenting anemia (Hb Results: The study included 370 individuals with a mean age of 46.83 (± 12.18) years. 85.9% patients were females. Mean CDAI, SDAI, DAS-28 ESR & DAS-28 CRP scores were 16.75 (±13.56), 19.05 (±15.01), 4.75 (±1.53) and 4.05 (± 1.58) respectively. The mean hemoglobin was 9.69 (±0.99) g/dL and mean hemoglobin levels were highest in the remission group based on all the four disease activity indices. The mean hepcidin level was 71.44 (± 40.01) ng/ml. No significant difference between patient groups in terms of hepcidin and disease activity indices was observed, except for significantly higher levels in the low disease activity group based on DAS-28 ESR (χ2 = 10.837, p = 0.013). The study participants with serum ferritin levels > 100 ng/ml were grouped into anemia of chronic disease (AOCD), those with ferritin levels Conclusion: There was no significant difference in terms of age of participants in various groups based on disease activity indices. There was no significant difference between the age and gender groups in terms of hepcidin. Mean hepcidin levels were highest in patients with AOCD. No significant differences in hepcidin levels were observed among patients with varying levels of disease activity. Further research is warranted to unravel the underlying mechanisms and potential clinical implications of these findings. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: None declared.
Gupta et al. (2024) studied this question.