Diagnostic evaluation of anemia in inflammatory bowel disease: the potential role of soluble hemojuvelin.

OBJECTIVES

The differentiation of anemia types, particularly between iron deficiency anemia (IDA) and anemia of chronic disease, remains a major diagnostic challenge among patients with inflammatory bowel disease (IBD). This study aimed to evaluate the diagnostic performance of various iron parameters, with a specific focus on serum hemojuvelin (sHjv) as a potential biomarker of anemia in IBD.

METHODS

The study was conducted in the Gastroenterology Department of the University Hospital of Heraklion. Demographics, clinical and laboratory data, as well as sera from 152 consecutive IBD patients, were collected. Transferrin saturation, soluble transferrin receptor (sTFR), sTFR index, and hepcidin (Hpc) were assessed. In addition, sHjv levels were measured using a commercially available Elisa kit.

RESULTS

Eighty-nine patients (58.6%) had a history of anemia, whereas 40 (26.3%) were anemic at study entry. The majority of anemic patients (57.5%) had IDA. Receiver operating characteristic analysis demonstrated that sTFR more than 1.64 mg/L [area under the curve (AUC): 0.774] and sTFR index more than 1.06 (AUC: 0.921) were significant predictors for IDA diagnosis (both P < 0.001). Neither Hpc nor sHjv showed diagnostic utility for non-IDA anemia [cut-offs >31 317 pg/ml (AUC = 0.511, P = 0.9107) and ≤227.04 ng/ml (AUC = 0.612, P = 0.219), respectively]. Serum Hjv levels were negatively correlated with Hpc in all patients (-0.25) and in nonanemic patients (-0.29), both P < 0.05.

CONCLUSION

sTFR and particularly sTFR index are valuable diagnostic tools for identifying true IDA, whereas sHjv appears to have no diagnostic role but shows a consistent negative correlation with Hpc.