Clinical utility of serum hepcidin and iron profile measurements in Alzheimer's disease

Objectives: There are no generally accepted serum biomarkers for Alzheimer's disease (AD). We investigated the clinical usefulness of measuring the serum hepcidin levels and iron profile in patients with AD. Materials & methods: The iron profile and hepcidin levels were measured in patients with AD (N = 70), minimal cognitive impairment (MCI, N = 39), and vascular dementia (VD, N = 25) and normal controls (N = 124). General cognitive tests were performed, and the relationships between cognition and hepcidin levels or the iron profile were assessed. Results: Patients with AD had higher hepcidin values than those with MCI and VD and normal controls (median value: 39.00 vs. 30.81, 32.52, and 5.51 ng/ml, respectively, P < 0.001), and these differences were found in both men and women. The total iron-binding capacity was significantly lower in the AD group than in any other groups (308.0 vs. 332.0, 329.0, and 330.5 mu g/dl, respectively, P = 0.018), and serum iron levels were lower in the AD group than controls (79.1 vs. 107.2 mu g/dl, P = 0.007). Hepcidin levels were statistically significantly correlated with the clinical dementia rating (CDR, P = 0.040) with a Pearson's correlation coefficient of 0.253, and the patients with AD with a CDR value > 1 had significantly higher hepcidin values than those with a CDR value of 1 (65.26 vs. 23.49 ng/ml, P = 0.020). Conclusion: The measurement of serum hepcidin levels and the iron profile in patients with early manifestations of cognitive functional loss might aid in the diagnosis of AD and the assessment of disease severity when combined with other diagnostic parameters.