Hepcidin was measured in plasma by competition ELISA, using the hepcidin-25 (human) enzyme immunoassay kit (S-1337; Bachem, San Carlos, CA) with detection range 0.02–25 ng/mL, according to the manufacturer’s protocol. Plasma was diluted 1 in 4 in peptide-cleared human serum. Standards were run in duplicate and samples in singlicate, according to the manufacturer’s protocol. Samples giving readings outside the linear region of the curve were re-run at alternative dilutions. The intra-assay CV was mean 6.3% (range 5.7–6.9%), and inter-assay CV was 6.3%.
Iron deficiency was defined according to WHO guidelines, using a combination of low ferritin (< 12 μg/L in the absence of inflammation (CRP ≤ 5 mg/L) or < 30 μg/L in the presence of inflammation (CRP > 5 mg/L)) [30 , 31 ] plus evidence of iron depletion in the tissues, as evidenced by a sTfR/log10 ferritin (sTfR-F) index >2 [18 (link)]. Anemia of inflammation (AI) was defined as hemoglobin < 105 g/L at 3 and 6 months or < 100 g/L at 12 months and CRP >5 mg/L, with no iron deficiency (ferritin > 30 μg/L and sTfR/log10 ferritin (sTfR-F) index < 2).