{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:38:29Z","timestamp":1786649909070,"version":"build-2736575974"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>\n                    A\n                    <jats:sc>BSTRACT<\/jats:sc>\n                  <\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The bone marrow iron study is the gold standard for differentiation of the two most common causes of anemia i.e. iron deficiency anemia (IDA) and anemia of chronic disease (ACD) in the elderly. However, it is often not feasible to do bone marrow examination (BME) in every elderly anemic patient, due to its invasive nature. Hepcidin, a liver-derived peptide, has been identified as the key systemic regulator of iron homeostasis. Our study highlights the potential diagnostic role of serum hepcidin in the evaluation of anemia in elderly.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology:<\/jats:title>\n                    <jats:p>Hundred elderly patients (\u226560 years of age) having iron deficiency anemia (IDA) or anemia of chronic disease\/inflammation (ACD) were the study subjects with 15 age-matched healthy controls. All patients were evaluated with history, clinical examination, routine investigations (complete blood count, liver, and kidney function tests), iron profile, and serum hepcidin. The bone marrow iron study was done in every patient to categorize them as IDA and ACD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results and Discussion:<\/jats:title>\n                    <jats:p>\n                      Serum iron, TIBC, MCV, ferritin, and serum transferrin saturation values were differing significantly between IDA and ACD groups. Serum hepcidin levels can be used confidently to differentiate ACD from IDA (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      value &lt;0.001). At serum concentration, 198.82 ng\/mL sensitivity of hepcidin to differentiate ACD from IDA was 93.9% and specificity was 92.2%. A subset of patients is misdiagnosed when the serum hepcidin level is used as a sole marker, and this also holds true for serum ferritin.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Though serum hepcidin level correlates well with serum iron profile and also serum hepcidin appears to be a useful marker to differentiate ACD from IDA in terms of both sensitivity and specificity, the combined assessment of serum hepcidin and iron profile appears to be a better marker than ferritin and hepcidin alone. This could replace the use of bone marrow iron staining as a diagnostic tool in anemia in elderly.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jfmpc.jfmpc_34_24","type":"journal-article","created":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T09:03:01Z","timestamp":1736758981000},"page":"356-362","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Serum hepcidin level with iron profile assay might replace bone marrow iron study as a diagnostic tool for evaluation of anemia in elderly without chronic renal disease"],"prefix":"10.4103","volume":"14","author":[{"given":"Sukdev","family":"Manna","sequence":"first","affiliation":[{"name":"Department of General Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India"},{"name":"Current affiliation: Department of Rheumatology and Clinical Immunology, All India Institute of Medical Sciences Kalyani, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sankha Shubhra","family":"Chakrabarti","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohit","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Indrajeet Singh","family":"Gambhir","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,1,13]]},"reference":[{"key":"R2-20260109","doi-asserted-by":"crossref","first-page":"2263","DOI":"10.1182\/blood-2004-05-1812","article-title":"Prevalence of anemia in persons 65 years and older in the United States: Evidence for a high rate of unexplained anemia","volume":"104","author":"Guralnik","year":"2004","journal-title":"Blood"},{"key":"R3-20260109","doi-asserted-by":"crossref","first-page":"572","DOI":"10.7326\/0003-4819-115-7-572","article-title":"Anemia of chronic disease: A misnomer","volume":"115","author":"Schilling","year":"1991","journal-title":"Ann Intern Med"},{"key":"R4-20260109","doi-asserted-by":"crossref","first-page":"2461","DOI":"10.1182\/blood-2002-10-3235","article-title":"Hepcidin, a putative mediator of anemia of inflammation, is a type II acute-phase protein","volume":"101","author":"Nemeth","year":"2003","journal-title":"Blood"},{"key":"R5-20260109","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1002\/stem.5530130105","article-title":"Pathogenesis of the anemia of chronic disease: A cytokine-mediated anemia","volume":"13","author":"Means","year":"1995","journal-title":"Stem Cells"},{"key":"R6-20260109","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/0002-9343(67)90013-7","article-title":"Primary defective iron reutilization: Response to testosterone therapy","volume":"42","author":"Haurani","year":"1967","journal-title":"Am J Med"},{"key":"R7-20260109","first-page":"265","article-title":"Cardiovascular adaptation to chronic anemia in the elderly: An echocardiographic study","volume":"27","author":"Aessopos","year":"2004","journal-title":"Clin Investig Med"},{"key":"R8-20260109","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1016\/0002-8703(72)90445-0","article-title":"Cardiovascular effects of anemia","volume":"83","author":"Varat","year":"1972","journal-title":"Am Heart J"},{"key":"R9-20260109","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1016\/S0002-9343(89)80396-1","article-title":"The anemia of chronic disease: Spectrum of associated diseases in a series of unselected hospitalized patients","volume":"87","author":"Cash","year":"1989","journal-title":"Am J Med"},{"key":"R10-20260109","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/0049-0172(90)90001-V","article-title":"The pathogenesis of anemia in rheumatoid arthritis: A clinical and laboratory analysis","volume":"19","author":"Baer","year":"1990","journal-title":"Semin Arthritis Rheum"},{"key":"R11-20260109","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1136\/ard.15.1.12","article-title":"Nature of anaemia in rheumatoid arthritis: II. Survival of transfused erythrocytes in patients with rheumatoid arthritis","volume":"15","author":"Alexander","year":"1956","journal-title":"Ann Rheum Dis"},{"key":"R12-20260109","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/0002-9343(64)90212-8","article-title":"The diagnosis of iron deficiency anemia","volume":"37","author":"DF","year":"1964","journal-title":"Am J Med"},{"key":"R13-20260109","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1001\/archopht.1983.01040020051008","article-title":"Retinal abnormalities associated with anemia","volume":"101","author":"Aisen","year":"1983","journal-title":"Arch Ophthalmol"},{"key":"R14-20260109","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1016\/0002-9394(68)90818-0","article-title":"Retinopathy in severe anemia","volume":"66","author":"Merin","year":"1968","journal-title":"Am J Ophthalmol"},{"key":"R15-20260109","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1056\/NEJM196905222802108","article-title":"Red-cell 2, 3-diphosphoglycerate levels in subjects with chronic hypoxemia","volume":"280","author":"Oski","year":"1969","journal-title":"N Engl J Med"},{"key":"R16-20260109","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.7326\/0003-4819-55-6-1004","article-title":"Papilledema associated with blood loss anemia","volume":"55","author":"Schwaber","year":"1961","journal-title":"Ann Intern Med"},{"key":"R17-20260109","doi-asserted-by":"crossref","first-page":"3672","DOI":"10.1002\/art.30623","article-title":"Hepcidin and haemoglobin content parameters in the diagnosis of iron deficiency in Rheumatoid Arthritis patients with anaemia","volume":"63","author":"Van Santen","year":"2011","journal-title":"Arthritis Rheum"},{"key":"R18-20260109","doi-asserted-by":"crossref","first-page":"4292","DOI":"10.1182\/blood-2008-02-139915","article-title":"Immunoassay for human serum hepcidin","volume":"112","author":"Ganz","year":"2008","journal-title":"Blood"},{"key":"R19-20260109","doi-asserted-by":"crossref","first-page":"5277","DOI":"10.1182\/blood-2008-12-195651","article-title":"Regulation of iron homeostasis in anemia of chronic disease and iron deficiency anemia: Diagnostic and therapeutic implications","volume":"113","author":"Theurl","year":"2009","journal-title":"Blood"},{"key":"R20-20260109","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1111\/j.1751-553X.2010.01265.x","article-title":"Serum hepcidin-25 may replace the ferritin index in the Thomas plot in assessing iron status in anemic patients","volume":"33","author":"Thomas","year":"2011","journal-title":"Int J Lab Hematol"},{"key":"R21-20260109","doi-asserted-by":"crossref","first-page":"448","DOI":"10.3324\/haematol.2012.068825","article-title":"Plasma hepcidin levels and anemia in old age. The Leiden 85-Plus Study","volume":"98","author":"Den Elzen","year":"2013","journal-title":"Haematologica"},{"key":"R22-20260109","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1007\/s10238-010-0102-9","article-title":"Hepcidin expression in anemia of chronic disease and concomitant iron-deficiency anemia","volume":"11","author":"Cheng","year":"2011","journal-title":"Clin Exp Med"}],"container-title":["Journal of Family Medicine and Primary Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jfmpc.jfmpc_34_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:59:47Z","timestamp":1786647587000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jfmpc.jfmpc_34_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":21,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/jfmpc.jfmpc_34_24","relation":{},"ISSN":["2249-4863","2278-7135"],"issn-type":[{"value":"2249-4863","type":"print"},{"value":"2278-7135","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2024-01-07","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-17","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}