Lotfi Ramin, Kroll Christine, Plonné Dietmar, Jahrsdörfer Bernd, Schrezenmeier Hubert
Institute for Transfusion Medicine, University Hospital Ulm, Ulm, Germany; Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Services Baden-Württemberg-Hessen, Ulm, Germany.
Institute for Clinical Transfusion Medicine and Immunogenetics Ulm, German Red Cross Blood Services Baden-Württemberg-Hessen, Ulm, Germany.
Transfus Med Hemother. 2015 Nov;42(6):390-5. doi: 10.1159/000440825. Epub 2015 Nov 3.
Iron supplementation is generally recommended for blood donors even though there are inter-individual differences in iron homeostasis.
Ferritin levels of repeat donors were compared with first-time donors, retrospectively. Prospectively, we tested 27 male repeat donors for the following parameters at the day of blood donation as well as 1, 3, 7, 10, and 56 days thereafter: ferritin, hepcidin, transferrin, transferrin receptor, hemoglobin, erythropoietin, reticulocytes, hemoglobin in reticulocyte, twisted gastrulation protein homolog 1, and growth differentiation factor-15.
56 days after blood donation, donors' average ferritin dropped to 55% (range 30-100%) compared to the initial value. Of all tested parameters hepcidin showed the highest and most significant changes beginning 1 day after donation and lasting for the whole period of 56 days. Along with ferritin, there was a high variation in hepcidin levels indicating inter-individual differences in hepcidin response to iron loss. Donors with a hepcidin/ferritin quotient < 0.3 regained 60% of their initial ferritin after 56 days, while those with a quotient ≥ 0.3 reached less than 50%.
As hepcidin appears to integrate erythropoietic and iron-loading signals, clinical measurement of hepcidin (together with the hepcidin-ferritin ratio) may become a useful indicator of erythropoiesis and iron kinetics.
尽管铁稳态存在个体差异，但一般仍建议献血者补充铁剂。
回顾性比较多次献血者与首次献血者的铁蛋白水平。前瞻性地，我们在献血当天以及此后第1、3、7、10和56天对27名男性多次献血者进行了以下参数检测：铁蛋白、铁调素、转铁蛋白、转铁蛋白受体、血红蛋白、促红细胞生成素、网织红细胞、网织红细胞内血红蛋白、扭结 gastrulation 蛋白同源物1和生长分化因子-15。
献血后56天，与初始值相比，献血者的平均铁蛋白降至55%（范围为30 - 100%）。在所有检测参数中，铁调素显示出最高且最显著的变化，从献血后1天开始并持续整个56天。与铁蛋白一样，铁调素水平存在很大差异，表明个体对铁流失的铁调素反应存在差异。铁调素/铁蛋白商数<0.3的献血者在56天后恢复了其初始铁蛋白的60%，而商数≥0.3的献血者恢复不到50%。
由于铁调素似乎整合了促红细胞生成和铁负荷信号，铁调素（连同铁调素 - 铁蛋白比值）的临床测量可能成为促红细胞生成和铁动力学的有用指标。
