Eleftheriadis Theodoros, Kartsios Charalambos, Liakopoulos Vassilios, Antoniadi Georgia, Ditsa Maria, Papadopoulos Christos, Anifandis Georgios, Skirta Aliki, Markala Dimitra, Stefanidis Ioannis
Department of Nephrology, University of Thessaly, Larissa, Greece.
Acta Haematol. 2006;116(4):238-44. doi: 10.1159/000095873.
Prohepcidin is the precursor of hepcidin, a liver-derived peptide involved in iron metabolism by blocking its intestinal absorption and its release by the reticuloendothelial system. Iron overload and inflammation increase hepcidin expression, whereas anemia and hypoxia suppress it. In the present study prohepcidin levels were determined in the serum of hemodialysis (HD) patients and its correlations with iron metabolism markers, C-reactive protein (CRP) and hematocrit (Hct) were assessed.
Forty-sixHD patients and 22 healthy volunteers were enrolled in the study. Hct, serum prohepcidin, CRP, iron, ferritin, transferrin saturation and transferrin receptors were measured. The weekly erythropoietin dose, last-month intravenous iron dose and the patients' demographics were recorded.
In comparison to the healthy volunteers, the HD patients had higher serum ferritin, transferrin receptors and CRP, lower serum iron and similar transferrin saturation and prohepcidin levels. In the patient group prohepcidin levels were negatively correlated with Hct but not with any other of the examined parameters. Multiple linear regression analysis considering age, inflammation, iron adequacy, erythropoietin dose and prohepcidin levels revealed that prohepcidin was the predominant determinant of Hct.
Taking into account the low Hct levels in the HD patients of our study, it seems plausible that the prohepcidin levels assessed in this group are inappropriately high. These functionally high prohepcidin levels may be associated with the factors that inhibit erythropoiesis in HD patients. On the other hand, the absence of other expected correlations indicates that further studies are needed in order to definitely clarify this aspect.
前铁调素是铁调素的前体，铁调素是一种肝脏来源的肽，通过阻断肠道对铁的吸收以及网状内皮系统对铁的释放来参与铁代谢。铁过载和炎症会增加铁调素的表达，而贫血和缺氧则会抑制其表达。在本研究中，测定了血液透析（HD）患者血清中的前铁调素水平，并评估了其与铁代谢标志物、C反应蛋白（CRP）和血细胞比容（Hct）的相关性。
46例HD患者和22名健康志愿者参与了本研究。测定了Hct、血清前铁调素、CRP、铁、铁蛋白、转铁蛋白饱和度和转铁蛋白受体。记录了每周促红细胞生成素剂量、上月静脉铁剂量以及患者的人口统计学数据。
与健康志愿者相比，HD患者的血清铁蛋白、转铁蛋白受体和CRP较高，血清铁较低，转铁蛋白饱和度和前铁调素水平相似。在患者组中，前铁调素水平与Hct呈负相关，但与其他任何检测参数均无相关性。考虑年龄、炎症、铁充足性、促红细胞生成素剂量和前铁调素水平的多元线性回归分析显示，前铁调素是Hct的主要决定因素。
考虑到我们研究中HD患者的Hct水平较低，该组中评估的前铁调素水平似乎过高，这似乎是合理的。这些功能上较高的前铁调素水平可能与抑制HD患者红细胞生成的因素有关。另一方面，缺乏其他预期的相关性表明，需要进一步研究以明确这一方面。
