Serum Ferritin, Hepcidin, and the Iron-Inflammation Axis in Patients with Rheumatoid Arthritis in Kaduna State

Anaemia of chronic inflammation, driven by hepcidin-mediated iron sequestration, is a common and debilitating complication of rheumatoid arthritis. This study investigates serum ferritin, hepcidin, and iron metabolism indices in patients with rheumatoid arthritis, exploring the interplay between inflammatory activity and iron homeostasis at a rheumatology clinic in Kaduna State, North West Nigeria. A cross-sectional analytical design was employed, recruiting 100 patients with ACR/EULAR-criteria rheumatoid arthritis and 80 healthy controls. Serum ferritin, hepcidin (measured by competitive ELISA), serum iron, total iron-binding capacity, and transferrin saturation were determined. Inflammatory activity was quantified by DAS-28 score, erythrocyte sedimentation rate, CRP, and IL-6. Haemoglobin and full blood count were also measured. Partial correlation analysis, controlling for inflammatory markers, was used to disentangle iron deficiency from inflammation-related ferritin elevation. The study examines whether hepcidin levels better discriminate iron deficiency from anaemia of inflammation than ferritin alone. Findings will contribute to optimised anaemia management in rheumatoid arthritis patients in North West Nigeria. Keywords: hepcidin, ferritin, rheumatoid arthritis, anaemia of inflammation, Kaduna State.