Nascimento Marcelo M, Suliman Mohamed E, Bruchfeld Annette, Hayashi Shirley Y, Manfro Roberto C, Qureshi Abdul Rashid, Pecoits-Filho Roberto, Pachaly Maria A, Renner Luciana, Stenvinkel Peter, Riella Miguel C, Lindholm Bengt
Faculdade Evangélica de Medicina do Paraná-Brazil.
Nephrol Dial Transplant. 2004 Dec;19(12):3112-6. doi: 10.1093/ndt/gfh508. Epub 2004 Oct 5.
Chronic liver disease and intravenous (i.v.) iron therapy can enhance oxidative stress. The aim of this study was to assess the influence of hepatitis C virus (HCV) and i.v. iron administration on oxidative stress in chronic haemodialysis (HD) patients.
A total of 115 HD patients (47% males, age 47 +/- 13 years) were placed in two groups according to the presence (HCV(+)) or absence (HCV(-)) of serum antibodies against HCV. Plasma pentosidine, high sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6) and alanine aminotransferase (ALT) levels were measured. The patients were also analysed according to the tertiles of serum levels of ferritin: group 1 (ferritin <380 ng/ml), group 2 (ferritin 380-750 ng/ml) and group 3 (ferritin >750 ng/ml). The cumulative iron dose was recorded during 6 months prior to the study.
HCV(+) patients had significantly higher levels of plasma pentosidine and ALT than HCV(-) patients. Age, gender, serum albumin, IL-6 and hsCRP did not differ according to HCV serology. The levels of pentosidine were related to the ferritin levels and were significantly higher in group 3 compared with group 1. Moreover, the cumulative dose of iron was significantly higher in group 3 than in group 1. Plasma pentosidine showed a positive correlation with age, HCV and ferritin. In a stepwise backward multiple regression model, age and HCV were independent predictors of pentosidine levels.
HCV in HD patients is associated with increased pentosidine levels, possibly reflecting increased oxidative stress. The association between pentosidine and ferritin levels may suggest an impact of i.v. iron therapy.
慢性肝病和静脉注射铁剂治疗可增强氧化应激。本研究旨在评估丙型肝炎病毒（HCV）和静脉注射铁剂对慢性血液透析（HD）患者氧化应激的影响。
根据血清抗HCV抗体的存在（HCV(+)）或不存在（HCV(-)），将总共115例HD患者（47%为男性，年龄47±13岁）分为两组。检测血浆戊糖苷、高敏C反应蛋白（hsCRP）、白细胞介素-6（IL-6）和丙氨酸转氨酶（ALT）水平。还根据血清铁蛋白水平的三分位数对患者进行分析：第1组（铁蛋白<380 ng/ml）、第2组（铁蛋白380 - 750 ng/ml）和第3组（铁蛋白>750 ng/ml）。记录研究前6个月的累积铁剂量。
HCV(+)患者的血浆戊糖苷和ALT水平显著高于HCV(-)患者。年龄、性别、血清白蛋白、IL-6和hsCRP根据HCV血清学无差异。戊糖苷水平与铁蛋白水平相关，第3组显著高于第1组。此外，第3组的累积铁剂量显著高于第1组。血浆戊糖苷与年龄、HCV和铁蛋白呈正相关。在逐步向后多元回归模型中，年龄和HCV是戊糖苷水平的独立预测因素。
HD患者中的HCV与戊糖苷水平升高有关，可能反映氧化应激增加。戊糖苷与铁蛋白水平之间的关联可能提示静脉注射铁剂治疗的影响。
