Hong Jun Hwa, Choi Yeon-Kyung, Min Byong-Keol, Park Kang Seo, Seong Kayeon, Lee In Kyu, Kim Jung Guk
Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, South Korea.
Department of Biomedical Science, Graduate School, Kyungpook National University, Daegu, South Korea; BK21 Plus KNU Biomedical Convergence Program (Brain Korea 21 Plus Project for Bio-Medical Convergence Program for Creative Talent), Kyungpook National University, Daegu 702-701, South Korea.
Diabetes Res Clin Pract. 2015 Jul;109(1):64-70. doi: 10.1016/j.diabres.2015.05.001. Epub 2015 May 11.
Despite the absence of overt renal impairment and decreased erythropoietin (EPO) levels, patients are usually anemic. Hepcidin, which is induced by inflammatory stimuli, plays an important role in anemia in chronic disease. Growth differentiation factor 15 (GDF15) is a putative anti-inflammatory cytokine that is elevated in type 2 diabetes (T2DM). Hence, we investigated the relationship between hepcidin and GDF15 in anemic T2DM patients without overt renal impairment.
Among 1150 patients who visited Kyungpook National University Hospital for T2DM between June 2006 and June 2014, we selected 55 anemic patients without overt renal impairment (serum creatinine <1.5 mg/dL or estimated glomerular filtration rate >60 mL/min/1.73 m(2)) and other co-morbid diseases, including malignancy, thyroid disease, rheumatic arthritis, liver disease, iron-deficiency anemia and other endocrine disease. We measured anthropometric and metabolic parameters, as well as measured the serum iron, ferritin, interleukin-6 (IL-6), erythropoietin, hepcidin-25 and GDF15 levels.
Anemic T2DM patients without overt renal impairment presented a greater inflammatory state, with increased serum hsCRP, ESR and IL-6 levels compared with non-anemic T2DM patients. Both hepcidin and GDF15 levels were increased and showed a positive correlation in anemic T2DM patients.
In the absence of overt renal impairment, anemia in T2DM is associated with chronic inflammation, inducing elevation of hepcidin and GDF15 levels independently of the erythropoietin level.
尽管没有明显的肾功能损害且促红细胞生成素（EPO）水平降低，但患者通常仍会贫血。由炎症刺激诱导产生的铁调素在慢性病贫血中起重要作用。生长分化因子15（GDF15）是一种假定的抗炎细胞因子，在2型糖尿病（T2DM）中升高。因此，我们研究了无明显肾功能损害的贫血T2DM患者中铁调素与GDF15之间的关系。
在2006年6月至2014年6月期间因T2DM就诊于庆北国立大学医院的1150例患者中，我们选择了55例无明显肾功能损害（血清肌酐<1.5mg/dL或估计肾小球滤过率>60mL/min/1.73m²）且无其他合并疾病的贫血患者，这些合并疾病包括恶性肿瘤、甲状腺疾病、风湿性关节炎、肝脏疾病、缺铁性贫血和其他内分泌疾病。我们测量了人体测量学和代谢参数，以及血清铁、铁蛋白、白细胞介素-6（IL-6）、促红细胞生成素、铁调素-25和GDF15水平。
无明显肾功能损害的贫血T2DM患者呈现出更高的炎症状态，与非贫血T2DM患者相比，血清hsCRP、ESR和IL-6水平升高。贫血T2DM患者的铁调素和GDF15水平均升高且呈正相关。
在无明显肾功能损害的情况下，T2DM患者的贫血与慢性炎症相关，导致铁调素和GDF15水平升高，且与促红细胞生成素水平无关。
