Yayar Özlem, Eser Barış, Kılıç Harun
Department of Nephrology, Hitit University, Erol Olcok Training and Research Hospital; Çorum-Turkey.
Anatol J Cardiol. 2018 Feb;19(2):117-122. doi: 10.14744/AnatolJCardiol.2017.8019. Epub 2018 Jan 17.
In hemodialysis (HD) patients, cardiovascular disease (CVD) is the major cause of mortality and morbidity. In atherosclerotic diseases, iron gets accumulated in the arterial wall. Hepcidin is an important hormone in iron metabolism. Furthermore, hepcidin is associated with atherosclerotic disease. Therefore, this study aims to investigate the relation of serum hepcidin-25 (SH-25) and sub-clinic atherosclerosis measured by carotid intima-media thickness (CIMT) and mortality in HD patients.
We enrolled 82 HD patients in a cross-control study. We measured SH-25 using ELISA kit and CIMT using high-resolution real-time ultrasonography. After 4 years of first assessment, we investigated the relation between all-cause and cardiovascular mortality and SH-25 and CIMT.
Two patients were excluded because of renal transplantation. The survivors were younger (53.7±15.1 vs. 65.2±15.5; p<0.05) and CIMT was lower (0.83±0.2 vs. 0.95±0.2; p<0.05); however, there was no significant difference in SH-25 levels between the groups (29.1±13 vs. 32.4±22.4; p=0.767). The patients who died of CVD were significantly older (63.7±16.1 vs. 53.7±15.1; p<0.05) and had significantly higher CIMT (0.94±0.2 vs. 83±0.2; p<0.05). The SH-25 levels were statistically significantly higher in patients who died of CVD (40.3±25 vs. 29.1±13; p<0.05). Linear regression analysis showed a positive correlation between CIMT and SH-25 in the study population and in those who died from CVD (r=0.41; p<0.05 and r=0.606; p<0.05, respectively).
This study suggests that hepcidin is effective in cardiovascular mortality and pathophysiology of subclinical atherosclerosis in HD patients.
在血液透析（HD）患者中，心血管疾病（CVD）是死亡和发病的主要原因。在动脉粥样硬化疾病中，铁在动脉壁中蓄积。铁调素是铁代谢中的一种重要激素。此外，铁调素与动脉粥样硬化疾病相关。因此，本研究旨在探讨血清铁调素-25（SH-25）与通过颈动脉内膜中层厚度（CIMT）测量的亚临床动脉粥样硬化以及HD患者死亡率之间的关系。
我们纳入了82例HD患者进行一项交叉对照研究。我们使用酶联免疫吸附测定（ELISA）试剂盒测量SH-25，并使用高分辨率实时超声检查测量CIMT。在首次评估4年后，我们研究了全因死亡率和心血管死亡率与SH-25和CIMT之间的关系。
两名患者因肾移植被排除。存活者更年轻（53.7±15.1对65.2±15.5；p<0.05）且CIMT更低（0.83±0.2对0.95±0.2；p<0.05）；然而，两组之间的SH-25水平无显著差异（29.1±13对32.4±22.4；p=0.767）。死于CVD的患者明显更年长（63.7±16.1对53.7±15.1；p<0.05）且CIMT显著更高（0.94±0.2对83±0.2；p<0.05）。死于CVD的患者的SH-25水平在统计学上显著更高（40.3±25对29.1±13；p<0.05）。线性回归分析显示，在研究人群以及死于CVD的人群中，CIMT与SH-25呈正相关（分别为r=0.41；p<0.05和r=0.606；p<0.05）。
本研究表明，铁调素在HD患者的心血管死亡率和亚临床动脉粥样硬化的病理生理学中起作用。
