Estimation of serum hepcidin in oral submucous fibrosis before and after supplementation with oral iron: A randomized control clinical trial

J Oral Maxillofac Pathol. 2018 Sep-Dec;22(3):303-306. doi: 10.4103/jomfp.JOMFP_112_18.

Abstract

Background: Iron-deficiency anemia is synonymous with oral submucous fibrosis (OSMF). The cause for the same has not been ascertained yet. OSMF by way of anemia of chronic disease could be a probable cause of iron deficiency.

Aim and objective: This study was intended to evaluate the level of hemoglobin (Hb) in OSMF and to establish a relationship between serum hepcidin and Hb with OSMF, before and after oral supplementation of iron.

Materials and methods: The clinical trial was registered with the Clinical Trial Registry of India (CTRI/2016/03/006761). Eighty participants were selected. Based on the hematocrit values, they were divided into equal number of case (Group I) and control (Group II). Serum hepcidin was evaluated in these eighty participants with clinically established OSMF. Participants in the case group with low hematocrit values indicative of iron-deficiency anemia were supplemented with oral iron capsules twice daily for 3 months. After an interval of 3 months, serum hepcidin and hematocrit were evaluated.

Statistics: Statistical analysis was done using SPSS software version 11.5 (IBM, New York, USA). One-way ANOVA test was done to assess the correlation between Hb% and serum hepcidin. Unpaired t-test was done to correlate Hb% and hepcidin before and after oral supplementation of iron. Clinical significance was established by calculating the effect size.

Results: There was a significant correlation between the values of serum hepcidin and Hb (P < 0.001) before and after oral supplementation of elemental iron. After oral supplementation of iron, hematocrit improved in Group I along with reduction in serum hepcidin.

Conclusion: It can be concluded that reduction of serum hepcidin is indicative of improvement in iron stores of body. Hence, serum hepcidin can be utilized as a diagnostic marker to assess iron stores in OSMF.

Keywords: Anemia; hepcidin; iron stores; oral submucous fibrosis.