慢性肾脏病患者的血清 hepcidin-25 水平与肾小球滤过率无关。
Serum hepcidin-25 levels in patients with chronic kidney disease are independent of glomerular filtration rate.
机构信息
Department of Nephrology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
出版信息
Nephrol Dial Transplant. 2010 Mar;25(3):848-53. doi: 10.1093/ndt/gfp546. Epub 2009 Oct 23.
BACKGROUND
Hepcidin is a key regulator of iron homeostasis and levels are elevated in patients with chronic kidney disease (CKD). Hepcidin may explain the often observed imbalance in iron metabolism in patients with CKD. We evaluated the influence of estimated glomerular filtration rate (eGFR) on serum levels of hepcidin-25 and its isoforms in patients with renal dysfunction.
METHODS
Serum levels of the biologically active hepcidin-25 and its isoforms were determined in CKD and dialysis patients by a mass spectrometry-based assay.
RESULTS
In 83 patients with CKD not requiring dialysis, serum hepcidin-25 levels were not significantly increased (5.1 nM versus 4.2 nM, P = 0.30) and positively correlated with ferritin (r = 0.74, P < 0.01). Multiple regression analysis showed ferritin to be the only significant predictor of hepcidin-25 levels. Serum hepcidin-25 levels were not dependent on eGFR. In contrast, hepcidin-20 and total hepcidin levels showed an independent significant inverse correlation with eGFR. In 48 haemodialysis patients, median hepcidin-25 levels were significantly higher than in CKD patients (9.4 nM versus 5.1 nM, P < 0.001) and again strongly correlated with ferritin (r = 0.79, P < 0.001).
CONCLUSIONS
eGFR is not a major determinant of serum hepcidin-25 levels. In contrast, the hepcidin isoforms hepcidin-20 and hepcidin-22 accumulate in patients with renal impairment.
背景
铁调素是铁稳态的关键调节剂，在慢性肾脏病（CKD）患者中升高。铁调素可能解释了 CKD 患者中经常观察到的铁代谢失衡。我们评估了估计肾小球滤过率（eGFR）对肾功能障碍患者血清铁调素-25 及其同工型水平的影响。
方法
通过基于质谱的测定法，在 CKD 和透析患者中测定生物活性铁调素-25 及其同工型的血清水平。
结果
在 83 名不需要透析的 CKD 患者中，血清铁调素-25 水平没有显著升高（5.1 nM 与 4.2 nM，P = 0.30），且与铁蛋白呈正相关（r = 0.74，P < 0.01）。多元回归分析表明，铁蛋白是铁调素-25 水平的唯一显著预测因子。血清铁调素-25 水平与 eGFR 无关。相比之下，铁调素-20 和总铁调素水平与 eGFR 呈独立显著负相关。在 48 名血液透析患者中，铁调素-25 水平中位数明显高于 CKD 患者（9.4 nM 与 5.1 nM，P < 0.001），且与铁蛋白再次强烈相关（r = 0.79，P < 0.001）。
结论
eGFR 不是血清铁调素-25 水平的主要决定因素。相比之下，铁调素同工型铁调素-20 和铁调素-22 在肾功能损害患者中积聚。
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