Malyszko Jolanta, Koc-Zorawska Ewa, Levin-Iaina Nomy, Slotki Itzchak, Matuszkiewicz-Rowinska Joanna, Glowinska Irena, Malyszko Jacek S
2 Department of Nephrology, Medical University, Bialystok, Poland.
1 Department of Nephrology, Medical University, Bialystok, Poland.
Arch Med Sci. 2014 Dec 22;10(6):1117-22. doi: 10.5114/aoms.2014.47823.
All living organisms have evolved sophisticated mechanisms to maintain appropriate iron levels in their cells and within their body. Recently our understanding of iron metabolism has dramatically increased. Overt labile plasma iron (LPI) represents a component of non-transferrin bound iron (NTBI) that is both redox active and chelatable, capable of permeating into organs and inducing tissue iron overload. The LPI measures the iron-specific capacity of a given sample to produce reactive oxygen species. We studied for the first time NTBI correlations with markers of iron status and inflammation in prevalent hemodialyzed patients.
Complete blood count, urea, serum lipids, fasting glucose, creatinine, ferritin, serum iron, total iron binding capacity (TIBC) were studied by standard laboratory method. The NTBI was assessed commercially available kits from Aferrix Ltd in Tel Aviv, Israel. A test result of 0.6 units of LPI or more indicates a potential for iron-mediated production of reactive oxygen species in the sample.
Patients with LPI units ≥ 0.6 had higher serum iron, erythropoiesis stimulating agents (ESA) dose, ferritin, high-sensitivity C-reactive protein (hsCRP), hepcidin and lower hemojuvelin. In hemodialyzed patients NTBI correlated with hsCRP (r = 0.37, p < 0.01), ferritin (r = 0.41, p < 0.001), IL-6 (r = 0.43, p < 0.001). In multivariate analysis predictors of NTBI were hemoglobin and alkaline phosphatase, explaining 58% of the variability.
Elevated NTBI in HD may be due to disturbed iron metabolism. Anemia and liver function might also contribute to the presence of NTBI in this population.
所有生物都进化出了复杂的机制来维持细胞和体内适当的铁水平。最近，我们对铁代谢的理解有了显著提高。明显的不稳定血浆铁（LPI）是非转铁蛋白结合铁（NTBI）的一个组成部分，它具有氧化还原活性且可螯合，能够渗透到器官中并导致组织铁过载。LPI测量给定样本产生活性氧的铁特异性能力。我们首次研究了NTBI与普遍存在的血液透析患者铁状态和炎症标志物之间的相关性。
通过标准实验室方法研究全血细胞计数、尿素、血脂、空腹血糖、肌酐、铁蛋白、血清铁、总铁结合力（TIBC）。NTBI使用以色列特拉维夫Aferrix Ltd公司的市售试剂盒进行评估。LPI为0.6单位或更高的测试结果表明样本中存在铁介导的活性氧产生的可能性。
LPI单位≥0.6的患者血清铁、促红细胞生成素（ESA）剂量、铁蛋白、高敏C反应蛋白（hsCRP）、铁调素较高，而血色素沉着蛋白较低。在血液透析患者中，NTBI与hsCRP（r = 0.37，p < 0.01）、铁蛋白（r = 0.41，p < 0.001）、白细胞介素-6（r = 0.43，p < 0.001）相关。在多变量分析中，NTBI的预测指标是血红蛋白和碱性磷酸酶，可解释58%的变异性。
血液透析患者中NTBI升高可能是由于铁代谢紊乱。贫血和肝功能也可能导致该人群中NTBI的存在。
