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The purpose of the present study was to specify a role of inflammatory mediators in pathogenesis of various types of anemia in pregnant obese women. We determined IL-1, IL-6, TNFα, C-reactive protein and hepcidin concentrations in blood serum of pregnant women with obesity depending on the type of anemic syndrome, either iron-deficiency anemia, or anemia of chronic diseases. We showed that the content of IL-6 in blood of the obese women exceeds the value of this index in healthy pregnant women (p < 0.05), and it does not depend on the presence and type of anemic syndrome. We found that the C-reactive protein concentration in pregnant women with obesity is higher than reference values (p < 0.05). Moreover, the contents of C-reactive protein in blood serum of pregnant women with anemia of chronic diseases is significantly higher (p < 0.05) than in women with iron deficiency anemia. Hepcidin concentration in blood of pregnant women with obesity and anemia of chronic disease was a specific feature: its content was significantly higher than in healthy pregnant women (p < 0.05), or in pregnant women with anemia-free obesity (p < 0.05). Hepcidin levels also exceeded 2-fold its contents in serum from pregnant women with obesity and iron deficiency anemia (p < 0.05). We have found that only pregnant women with obesity and anemia of chronic diseases have shown a positive correlation between the concentrations of C-reactive protein and blood levels of hepcidin (r = 0.733, p < 0.05), or IL-6 (r = 0.679, p < 0.05).The discussion concerns potential mechanisms of evolving anemia of chronic disease combined with subclinical inflammation in pregnant women with metabolic disorders. We conclude that a combination of obesity with gestational diabetes is a risk factor of anemia of chronic diseases in pregnant women. Development of an algorithm for differential diagnosis of iron deficiency anemia and anemia of chronic diseases in this cohort of patients is advisable for future studies in the area.

The review is dedicated to the diagnostics of hypochromic microcytic anemia among pregnant women with carbohydrate metabolism disorders by means of existing laboratory algorithm of examination. We give some data on the anemic syndrome in women with diabetes mellitus type 1. These data demonstrate an equal occurrence of anemia of chronic disorder and iron-deficiency anemia in this group of patients. Special attention is paid to the role of hepcidin in iron metabolism as well as to the mechanisms of regulation of hepcidin production under normal and pathological conditions. The review cites researches, which demonstrate the effectiveness of hepcidin measurement for differential diagnostics of anemic syndrome. We also touch upon the problem concerning treatment of anemia of chronic disorder.