Serum prohepcidin and other iron metabolism parameters in elderly patients with anemia of chronic disease and with iron deficiency anemia

Serum prohepcidin and other iron metabolism parameters... 105INTROduCTION Anemia of chronic disease (ACD) and iron-deficiency anemia (IDA) are common hematological conditions present in elderly patients. [1]2][3] They are a risk factor for cardiovascular diseases, contribute to fatigue, and negatively affect cognitive and physical functions as well as the quality of life. 4ACD is a typically micro-or normocytic, normochromic anemia associated with chronic infections, chronic noninfectious inflammatory diseases, and malignancies.The pathogenesis of ACD is multifactorial.It involves impaired erythropoietin-dependent erythropoiesis caused by proinflammatory cytokines (interleukin 6 [IL-6], C-reactive protein [CRP], and tumor necrosis factor-α), impaired iron mobilization, and shortened red blood cell survival. 4-8IDA develops, in the most part, due to chronic blood loss from the gastrointestinal tract, caused by aspirin or other nonsteroidal anti-inflammatories, ulcers, colon cancer, or diverticulosis. 3Other causes of chronic blood loss or iron deficiency due to poor nutrition in this patient group are less likely. [9][0][11][12] In the elderly population, severe IDA may also affect the production of other proteins containing Fe 2+ , such as cytochromes, myoglobin, catalase, and peroxidase.