Date Published: 
Friday, 12 July, 2013

Serum hepcidin may be a clinical biomarker for brain iron deposition in HBV-related cirrhotic patients, research suggests

Professor Jorge Toblli

This article highlights the importance of the relationship between serum hepcidin and iron deposition in the brain of patients with HBV-related cirrhosis. The study is based on a group of HBV-related cirrhotic patients and age- and sex-matched healthy controls.  The evaluation of brain iron content was conducted by susceptibility weighted phase imaging technique.

The authors conclude that decreased serum hepcidin level correlated with excessive iron accumulation in the basal ganglia in HBV-related cirrhotic patients. Consequently, these results suggest that serum hepcidin might be a clinical biomarker for brain iron deposition in cirrhotic patients. This may contribute to a better therapeutic approach in this population of patients.

This research is published in the June 2013 edition of PLoS One.

Data summary

This study measured brain iron content in 70 patients with hepatitis B virus (HBV)-related cirrhosis and compared it to that of 40 age- and sex-matched healthy controls. Cirrhotic patients had increased iron accumulation (mg per 100g wet weight) compared with controls in seven brain regions.

Brain region

Iron accumulation (mg/100g wet weight)

Patients  Controls
Left red nucleus 22.96 ± 9.01 17.58 ± 6.64  p=0.001 
Bilateral substantia nigra (right)  24.90 ± 9.36 19.68 ± 6.86  p=0.001
Bilateral substantia nigra (left) 32.06 ± 8.22 27.09 ± 7.81  p=0.002
Bilateral thalamus (right) 4.83 ± 2.28 3.70 ± 1.56  p=0.007
Bilateral thalamus (left) 5.54 ± 1.98 4.44 ± 2.00  p=0.006
Right caudate 16.71 ± 4.17 13.49 ± 5.17  p=0.001
Right putamen 10.05 ± 5.22 7.79 ± 4.53  p=0.024

Additionally, cirrhotic patients had decreased serum hepcidin concentration, serum transferrin and total iron binding capacity (TIBC), and increased transferrin saturation (TSAT), compared with controls.

Patients with hepatic cirrhosis exhibit a range of neurological conditions, with iron accumulation believed to play a role. Excessive iron deposition has been detected in patients with Parkinson’s disease, Alzheimer’s disease and multiple sclerosis, though the exact mechanism is unknown. In this study, serum hepcidin concentration negatively correlated with iron accumulation in the right caudate, indicating a potential therapeutic value of hepcidin as a clinical biomarker for brain iron deposition in cirrhotic patients.

What is hepcidin?