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The pathogenesis of malarial anemia is incompletely understood. Hepcidin, a recently discovered peptide hormone, is a major regulator of iron metabolism and is thought to play a central role in the anemia of chronic inflammation. The specific aim of the study was to characterize the association between urinary hepcidin, hemoglobin, and parasitemia in 199 patients presenting for evaluation of Plasmodium falciparum malaria in Ghana. Urinary hepcidin was semi-quantitatively assessed using surface-enhanced laser desorption/ionization time-of-flight mass spectrometry. Urinary hepcidin (intensity/mmol creatinine) was associated with log parasitemia in 86 children (beta = 0.086, standard error [SE] = 0.035, P < 0.017), 31 pregnant women (beta = 0.218, SE = 0.085, P < 0.016), and 82 adults (beta = 0.184, SE =0.043, P < 0.0001). Urinary hepcidin was not significantly associated with hemoglobin or anemia. Urinary hepcidin is more strongly associated with parasitemia than hemoglobin or anemia among patients with acute P. falciparum malaria in Ghana.
Received February 23, 2007. Accepted for publication July 5, 2007.
Acknowledgments: We thank Avindra Nath for the use of a Ciphergen Protein Chip Reader and Amanda Ray and Margaret Dayhoff-Brannigan for technical assistance.
Financial support: Supported in part by NIH R01 AG029148, WHO/ MIM/TDR Project No. A30033, Bill and Melinda Gates Institute for Population and Reproductive Health, Johns Hopkins University.
* Address correspondence to Richard Semba, 550 N. Broadway, Suite 700, Baltimore, MD 21205. E-mail: rdsemba{at}jhmi.edu
Authors addresses: Caitlin Howard, Kai Sun, David Sullivan, and Richard Semba, Johns Hopkins Medical Institutions, 550 N. Broadway, Suite 700, Baltimore, MD 21205. Uri McKakpo, Isabella Quakyi, Kwabena Bosompem, and Ebenezer Addison, School of Public Health and Noguchi Memorial Institute for Medical Research, University of Ghana. Legon, Accra, Ghana.
Reprint requests: Richard Semba, 550 N. Broadway, Suite 700, Baltimore, MD 21205. E-mail: rdsemba{at}jhmi.edu.
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