Hara Masaki, Ando Minoru, Tsuchiya Ken, Nitta Kosaku
Department IV of Internal Medicine, Tokyo Women's Medical University, 8-1, Kawadacho, Shinjuku-Ku, Tokyo, 162-0054, Japan.
Ann Hematol. 2015 Apr;94(4):603-8. doi: 10.1007/s00277-014-2255-1. Epub 2014 Dec 3.
Hepatic hepcidin-25 production is stimulated by systemic inflammation, and it interferes with the body's utilization of iron, leading to anemia. A 1-year prospective study was conducted to elucidate an association of serum hepcidin-25 concentration with mortality in anemic patients with non-Hodgkin lymphoma (NHL). Serum hepcidin-25 levels were measured in 50 NHL patients using liquid chromatography-tandem mass spectrometry. The patients were stratified into a high- and a low-hepcidin-25 group according to the median of serum hepcidin-25 concentrations. Factors associated with hemoglobin (Hb) were determined by multivariate regression analysis, incorporating serum hepcidin-25 and inflammatory markers including ferritin and interleukin-6 (IL-6) as covariates. The association between serum hepcidin-25 and mortality was analyzed using both the Kaplan-Meier method and a multivariate proportional hazards regression model. The median of serum hepcidin-25 concentrations was 49.8 (0.6-269) ng/mL, a level approximately nine times greater than the reference value for healthy individuals. Hb level was significantly lower in the high than in the low-hepcidin-25 group. Serum hepcidin-25 was extracted as the significant factor associated with Hb, but neither ferritin nor IL-6 was. The cumulative mortality was significantly greater in the high than in the low-hepcidin-25 group (56.0 vs. 24.0 %; P = 0.0222). The mortality risk for the presence of high hepcidin-25 was four times greater (hazard ratio [95 % confidence interval]: 3.66 [1.12-16.4]). In conclusion, serum hepcidin-25 levels are elevated in anemic NHL patients, and in this study, the group with higher hepcidin-25 levels manifested advanced anemia and poor survival.
全身性炎症会刺激肝脏产生铁调素-25，它会干扰人体对铁的利用，从而导致贫血。一项为期1年的前瞻性研究旨在阐明血清铁调素-25浓度与非霍奇金淋巴瘤（NHL）贫血患者死亡率之间的关联。使用液相色谱-串联质谱法对50例NHL患者的血清铁调素-25水平进行了测量。根据血清铁调素-25浓度的中位数，将患者分为高铁调素-25组和低铁调素-25组。通过多变量回归分析确定与血红蛋白（Hb）相关的因素，将血清铁调素-25以及包括铁蛋白和白细胞介素-6（IL-6）在内的炎症标志物作为协变量纳入分析。使用Kaplan-Meier方法和多变量比例风险回归模型分析血清铁调素-25与死亡率之间的关联。血清铁调素-25浓度的中位数为49.8（0.6 - 269）ng/mL，该水平约为健康个体参考值的9倍。高铁调素-25组的Hb水平显著低于低铁调素-25组。血清铁调素-25被确定为与Hb相关的重要因素，而铁蛋白和IL-6均不是。高铁调素-25组的累积死亡率显著高于低铁调素-25组（56.0%对24.0%；P = 0.0222）。高铁调素-25存在时的死亡风险高出四倍（风险比[95%置信区间]：3.66[1.12 - 16.4]）。总之，NHL贫血患者的血清铁调素-25水平升高，在本研究中，铁调素-25水平较高的组表现出严重贫血和较差的生存率。
