维持性血液透析患者血清 hepcidin 水平与心血管疾病的关系。

Relationship between serum hepcidin levels and cardiovascular disease in patients with maintenance hemodialysis.

机构信息

1Hemodialysis Center, Shanghai Yangsi Hospital, Pudong New Area, Shanghai, China.

2Hemodialysis Center, Yantai Affiliated Hospital of Binzhou Medical University, Yantai City, Shandong Province, China.

出版信息

Physiol Int. 2020 Dec 18;107(4):491-500. doi: 10.1556/2060.2020.00040.

DOI:10.1556/2060.2020.00040

PMID:33355540

Abstract

BACKGROUND

To investigate the serum level of hepcidin and its relationship with cardiovascular disease (CVD) in maintenance hemodialysis (MHD) patients.

METHODS

Blood was obtained from 75 MHD patients before undergoing hemodialysis and 20 healthy controls. Serum hepcidin, advanced oxidation protein products (AOPP) and interleukin (IL)-6 were measured by enzyme-linked immunosorbant assay (ELISA). Spearman correlation, and binary logistic regression linear regression analyses were used to assess the relationship between serum hepcidin and other parameters.

RESULTS

The serum level of hepcidin, AOPP and IL-6 was significantly up-regulated in MHD patients compared with the control (P < 0.05). Furthermore, serum hepcidin levels in patients with CVD were higher than those in patients without CVD (P < 0.05). In all MHD patients, serum hepcidin level was correlated positively with erythropoietin (EPO) dose per week (ρ = 0.251, P = 0.030), EPO resistance index (ρ = 0.268, P = 0.020), ferritin (ρ = 0.814, P < 0.001), transferin saturation (TSAT, ρ = 0.263, P = 0.023), AOPP (ρ = 0.280, P = 0.049), high sensitive C reactive protein (ρ = 0.151, P = 0.006), IL-6 (ρ = 0.340, P = 0.003) and left ventricular mass index (LVMI, ρ = 0.290, P = 0.033). Moreover, it was negatively correlated with serum pre-albumin (ρ = -0.266, P = 0.021), total iron-binding capacity (TIBC, ρ = -0.458, P < 0.001), unsaturated iron-binding capacity (UIBC, ρ = -0.473, P < 0.001) and transferrin (ρ = -0.487, P < 0.001). Linear regression analysis showed that ferritin (β = 0.708, P < 0.001), TIBC (β = -0.246, P = 0.032) and IL-6 (β = 0.209, P = 0.041) were independently associated with hepcidin. Results of binary logistic regression analysis suggested that higher serum hepcidin level (>249.2 ng/mL) was positively and independently related to CVD (OR = 1.32, 95% CI [1.20-9.56], P = 0.043).

CONCLUSIONS

Serum hepcidin level is associated with CVD in MHD patients, indicating that hepcidin may be a novel biomarker and therapeutic target for CVD.

摘要

背景

探讨维持性血液透析（MHD）患者血清铁调素水平及其与心血管疾病（CVD）的关系。

方法

采集 75 例 MHD 患者血液透析前和 20 例健康对照者的血液。采用酶联免疫吸附试验（ELISA）检测血清铁调素、晚期氧化蛋白产物（AOPP）和白细胞介素（IL）-6。采用 Spearman 相关分析和二元逻辑回归线性回归分析评估血清铁调素与其他参数之间的关系。

结果

与对照组相比，MHD 患者的血清铁调素、AOPP 和 IL-6 水平明显升高（P < 0.05）。此外，CVD 患者的血清铁调素水平高于无 CVD 患者（P < 0.05）。在所有 MHD 患者中，血清铁调素水平与每周红细胞生成素（EPO）剂量呈正相关（ρ=0.251，P=0.030），EPO 抵抗指数（ρ=0.268，P=0.020），铁蛋白（ρ=0.814，P<0.001），转铁蛋白饱和度（TSAT，ρ=0.263，P=0.023），AOPP（ρ=0.280，P=0.049），高敏 C 反应蛋白（ρ=0.151，P=0.006），IL-6（ρ=0.340，P=0.003）和左心室质量指数（LVMI，ρ=0.290，P=0.033）。此外，它与血清前白蛋白（ρ=-0.266，P=0.021）、总铁结合力（TIBC，ρ=-0.458，P<0.001）、不饱和铁结合力（UIBC，ρ=-0.473，P<0.001）和转铁蛋白（ρ=-0.487，P<0.001）呈负相关。线性回归分析表明，铁蛋白（β=0.708，P<0.001）、TIBC（β=-0.246，P=0.032）和 IL-6（β=0.209，P=0.041）与铁调素独立相关。二元逻辑回归分析结果表明，较高的血清铁调素水平（>249.2ng/mL）与 CVD 呈正相关且独立相关（OR=1.32，95%CI[1.20-9.56]，P=0.043）。