Qin Yan, Liu Hong, Ruan Shu, Cai Yi-feng, You Xue-fen, Song Guo-qi
Department of Hematology, The Affiliated Hospital of Nantong University, Nantong, China.
Zhonghua Xue Ye Xue Za Zhi. 2011 Nov;32(11):758-61.
To explore the application value of detection of Hepcidin together with indicator of iron overload on clinical diagnosis and treatment of MDS with iron overload by measuring Hepcidin and iron load indices of transfusion dependent myelodysplastic syndrome (MDS) patients.
Enzyme-linked immunosorbent assay (ELISA), radioimmunoassay and colorimetry were used to determine the Hepcidin, serum ferritin (SF) and serum iron (SI) levels of 106 serum samples from 68 cases of transfusion dependent MDS patients, 30 serum samples of MDS patients without transfusion and 60 serum samples of controls.
For MDS group, Hepcidin level in blood transfusion < 9 U subgroup was significantly higher than that in control group [(583 ± 50) µg/L vs (175 ± 35) µg/L] and there was a strong positive correlation between Hepcidin levels and SF (r = 0.976), but no correlation between Hepcidin and SI (r = 0.284); Both Hepcidin and SF level in transfusion 9 ∼ 24 U subgroup was significantly higher than those in control group [(665 ± 80) µg/L vs (175 ± 35) µg/L; (1445 ± 275) µg/L vs (112 ± 26)µg/L]; whereas for SI level, there was no difference between transfusion 9 ∼ 24 U subgroup and the control group. Hepcidin did not correlate with SF or SI; For blood transfusion > 24 U group, all of Hepcidin, SF and SI levels were higher than those in control groups [(703 ± 64) µg/L vs (175 ± 35) µg/L; (2587 ± 352) µg/L vs (112 ± 26)µg/L; (20 ± 4) µg/L vs (14 ± 4) µmol/L], Hepcidin negatively correlated with SF and SI (r = -0.536; r = -0.456). Hepcidin levels of RARS patients were significantly lower than RAEB patients [(260 ± 40) µg/L vs (442 ± 51) µg/L], and there was no significant difference between RARS group and control group regardless of the number of blood transfusion.
Both Hepcidin and SF levels in MDS patients regardless of transfusion dependent or not, or the number of blood transfused were higher than those of normal controls, the increase of Hepcidin can not synchronize with the increase of SF level due to the increased blood transfusion, when blood transfusion > 24 U, Hepcidin level showed a negative relationship with SF and SI, reflecting the decreased ability of Hepcidin to inhibit body iron absorption during the increase of blood transfusion, which finally would lead to iron overload. We can predict the occurrence of iron overload in transfusion dependent MDS patients by dynamic monitoring concentration of Hepcidin.
通过检测输血依赖型骨髓增生异常综合征（MDS）患者的铁调素（Hepcidin）及铁负荷指标，探讨Hepcidin联合铁过载指标在MDS伴铁过载临床诊疗中的应用价值。
采用酶联免疫吸附测定法（ELISA）、放射免疫测定法和比色法，检测68例输血依赖型MDS患者的106份血清样本、30例未输血MDS患者的血清样本及60份对照血清样本中的Hepcidin、血清铁蛋白（SF）和血清铁（SI）水平。
MDS组中，输血＜9 U亚组的Hepcidin水平显著高于对照组[（583±50）μg/L对（175±35）μg/L]，且Hepcidin水平与SF呈强正相关（r = 0.976），但与SI无相关性（r = 0.284）；输血9～24 U亚组的Hepcidin和SF水平均显著高于对照组[（665±80）μg/L对（175±35）μg/L；（1445±275）μg/L对（112±26）μg/L]；而SI水平在输血9～24 U亚组与对照组之间无差异，Hepcidin与SF或SI均无相关性；输血＞24 U组的Hepcidin、SF和SI水平均高于对照组[（703±64）μg/L对（175±35）μg/L；（2587±352）μg/L对（112±26）μg/L；（20±4）μg/L对（14±4）μmol/L]，Hepcidin与SF和SI呈负相关（r = -0.536；r = -0.456）。难治性贫血伴环形铁粒幼细胞增多（RARS）患者的Hepcidin水平显著低于难治性贫血伴原始细胞过多（RAEB）患者[（260±40）μg/L对（442±51）μg/L]，且无论输血次数多少，RARS组与对照组之间均无显著差异。
MDS患者无论是否输血依赖或输血次数多少Hepcidin和SF水平均高于正常对照，随着输血次数增加Hepcidin升高不能与SF同步，输血＞24 U时Hepcidin水平与SF和SI呈负相关，反映输血增加时Hepcidin抑制机体铁吸收能力下降，最终导致铁过载。通过动态监测Hepcidin浓度可预测输血依赖型MDS患者铁过载的发生。
