Lin Kao-Chang, Tsai Meng-Yi, Chi Chun-Ling, Yu Lai-King, Huang Li-Hsueh, Chen Chien-An
Department of Biotechnology, Southern Taiwan University, Tainan, Taiwan.
Department of Neurology, Chi-Mei Medical Center, Tainan, Taiwan.
Int Urol Nephrol. 2015 Nov;47(11):1847-53. doi: 10.1007/s11255-015-1090-1. Epub 2015 Sep 2.
Iron may contribute to vascular injury through reactive oxygen species. Hemodialysis patients frequently receive iron supply for correction of anemia and are at a high risk of cardiovascular disease. We tested the relationship between iron status and change in arterial stiffness in hemodialysis patients.
We measured iron status in 53 hemodialysis patients and studied the association with clinical, biochemical, and arterial stiffness measured by brachial-ankle pulse wave velocity (baPWV) over 3 years. The blood pressure was controlled to below 140/90 mmHg by anti-hypertensive drugs.
Median and interquartile range of baseline baPWV, baPWV at 3 years, and ΔbaPWV (difference between 3-year baPWV and baseline baPWV) were following: 17.6 (14.8-18.9), 16.9 (15.3-19.9), and 0.2 (-1.2 to 2.7) m/s. At baseline, baPWV was positively correlated with age, serum ferritin, and systolic blood pressure in univariate analysis. However, in multivariate analysis, only age and serum ferritin remained the significant determinants of baseline baPWV. After 3 years, ΔbaPWV was negatively correlated with age and positively with 3-year averaged serum ferritin in univariate analysis. Then, in multivariate analysis, only 3-year averaged serum ferritin was the important determinant of ΔbaPWV. ΔbaPWV was significantly increased in patients with 3-year averaged serum ferritin >500 ng/mL compared to patients with 3-year averaged serum ferritin ≤500 ng/mL.
In hemodialysis patients, serum ferritin associates with the progressive arterial stiffness, especially when serum ferritin >500 ng/mL.
铁可能通过活性氧导致血管损伤。血液透析患者经常接受铁补充以纠正贫血，且心血管疾病风险较高。我们测试了血液透析患者铁状态与动脉僵硬度变化之间的关系。
我们测量了53例血液透析患者的铁状态，并研究了其与临床、生化指标以及3年内通过肱踝脉搏波速度（baPWV）测量的动脉僵硬度之间的关联。通过抗高血压药物将血压控制在140/90 mmHg以下。
基线baPWV、3年时的baPWV以及ΔbaPWV（3年时的baPWV与基线baPWV之差）的中位数和四分位间距如下：17.6（14.8 - 18.9）、16.9（15.3 - 19.9）和0.2（-1.2至2.7）m/s。在基线时，单因素分析中baPWV与年龄、血清铁蛋白和收缩压呈正相关。然而在多因素分析中，只有年龄和血清铁蛋白仍然是基线baPWV的显著决定因素。3年后，单因素分析中ΔbaPWV与年龄呈负相关，与3年平均血清铁蛋白呈正相关。然后在多因素分析中，只有3年平均血清铁蛋白是ΔbaPWV的重要决定因素。与3年平均血清铁蛋白≤500 ng/mL的患者相比，3年平均血清铁蛋白>500 ng/mL的患者ΔbaPWV显著增加。
在血液透析患者中，血清铁蛋白与动脉僵硬度的进展相关，尤其是当血清铁蛋白>500 ng/mL时。
