Association Between IL-10 and Serum Hepcidin in Patients with β-Thalassemia Major: A Case-Control Study Using Multiple Statistical Modeling.

β-thalassemia major is a chronic, transfusion-dependent disorder marked by severe iron overload and systemic inflammation. However, the interplay among inflammatory cytokines, iron chelation therapy, and hepcidin regulation remains incompletely understood. In this case-control study, 140 participants (100 patients, 40 healthy controls) were examined for associations between inflammatory and biochemical parameters and serum hepcidin. Hematological and biochemical parameters, inflammatory cytokines (IL-10 and TNF-α), and serum hepcidin levels were evaluated using nonparametric tests, Spearman's correlation, and bootstrapped multiple linear regression, with adjustment for serum ferritin, hemoglobin, TNF-α, and age to account for potential confounding. Patients had significantly higher levels of ferritin, liver enzymes, blood glucose, inflammatory cytokines, and hepcidin than controls (p < 0.05). IL-10 and hepcidin showed a strong positive correlation (r = 0.838, p < 0.001). Bootstrapped Multiple regression showed that IL-10 was significantly associated with serum hepcidin in the adjusted model (B = 1.078, 95% CI: 0.876-1.288, p < 0.001), whereas ferritin was not independently associated with hepcidin. The model explained 74.2% of the variance (Adjusted R2 = 0.742). Moreover, significant variations in these parameters were observed across iron chelation therapy groups. These findings suggest a potential association between inflammatory activity and hepcidin-related iron regulation in β-thalassemia major, but longitudinal studies are needed to clarify the clinical relevance of this relationship.