Objectives: Hepcidin, a major regulator of iron metabolism and homeostasis. Studies on hepcidin in rheumatoid arthritis (RA) are still inconsistent. Aim to identify if hepcidin could add to diagnosis of RA associated complications, especially atherosclerosis.

Methods: A case-control study involved measurement of serum hepcidin levels in patients and control by Enzymelinked immunosorbent assay, and assessment of Carotid intima Media thickness (CIMT) by Doppler ultrasonography. Patients’ clinical manifestations, comorbidities, and treatment were recorded. The disease activity score-28 (DAS28) was used to evaluate RA activity.

Results: This study enrolled 50 RA patients and 25 control subjects, with predominantly female participants (98%). Hepcidin is significantly increased in RA patients when compared to control (p< 0.001). Right and Left Carotid intima media thickness showed significant difference between patients and control (p= 0.016 & p= 0.006). In multivariate linear regression models hepcidin showed significant positive correlation with BMI, CRP, CIMT (p< 0.001). Hepcidin level≥ 298.5 showed significant AUC that could discriminate between patients.

Conclusion: Increased hepcidin level in RA patients was correlated with CIMT (r= 0.676). Patient Age, RA duration, cholesterol level and hepcidin level were linked to an increase in CIMT in RA patients. Therefore, serum hepcidin level could be a predictor of atherosclerosis in RA patients.