Nita Eleni, Bairaktari Eleni, Kolios George, Migkos Michail P, Somarakis Georgios-Petros, Markatseli Theodora, Archimandriti Dimitra, Tsaousi Christina, Voulgari Paraskevi V
Microbiology Laboratory, University Hospital of Ioannina, Ioannina, Greece.
Laboratory of Clinical Chemistry, Medical School, University of Ioannina, Ioannina, Greece.
J Lab Physicians. 2021 Jul 15;13(4):317-322. doi: 10.1055/s-0041-1732827. eCollection 2021 Dec.
Anemia of chronic disease is a frequent consequence in rheumatoid arthritis and is associated with major clinical and patient outcomes. The present cross-sectional study explored the role of hepcidin (HEP) in anemia of chronic disease in rheumatoid arthritis by studying its relationships with markers of anemia, iron metabolism, inflammation, and erythropoiesis. Blood samples from anemic ( = 43) and nonanemic ( = 43) rheumatoid arthritis patients were analyzed for markers of anemia (hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, red cells distribution width, and reticulocyte hemoglobin), iron metabolism (iron, total iron binding capacity, ferritin, transferrin saturation, soluble transferrin receptor), inflammation (erythrocyte sedimentation rate, C-reactive protein, and interleukin 6), and erythropoiesis (erythropoietin and HEP). Correlation analysis was used to identify relationships between HEP and all other variables. Principal component analysis was used to identify common underlying dimensions representing linear combinations of all variables. HEP had statistically significant mostly moderate-to-large correlations with markers of anemia (0.30-0.70, all < 0.01), small correlation with markers of iron metabolism and markers of inflammation ( = 0.20-0.40, all < 0.01), and moderate correlations with markers of erythropoiesis. Principal component analysis revealed two underlying components (factors) capturing approximately 50% of total variability. Factor 1 comprised mainly of markers of anemia, iron metabolism, and erythropoiesis and was related to "erythrocyte health status," while factor 2 comprised mainly markers of inflammation and iron metabolism and was related to "acute phase reactants." HEP was the only variable demonstrating substantial loadings on both factors. HEP is related to markers of anemia, iron metabolism, inflammation, and erythropoiesis. In addition, when all variables are "reduced" to a minimum number of two "latent" factors, HEP is loaded on both, thus underlying its pivotal role in the complex interaction of the erythropoietic response in inflammation-induced anemia and/or functional iron deficiency.
慢性病性贫血是类风湿关节炎常见的后果，且与主要临床和患者结局相关。本横断面研究通过研究铁调素（HEP）与贫血、铁代谢、炎症及红细胞生成标志物之间的关系，探讨其在类风湿关节炎慢性病性贫血中的作用。对贫血（n = 43）和非贫血（n = 43）类风湿关节炎患者的血样进行分析，检测贫血标志物（血红蛋白、平均红细胞体积、平均红细胞血红蛋白含量、平均红细胞血红蛋白浓度、红细胞分布宽度和网织红细胞血红蛋白）、铁代谢标志物（铁、总铁结合力、铁蛋白、转铁蛋白饱和度、可溶性转铁蛋白受体）、炎症标志物（红细胞沉降率、C反应蛋白和白细胞介素6）以及红细胞生成标志物（促红细胞生成素和HEP）。采用相关性分析确定HEP与所有其他变量之间的关系。采用主成分分析确定代表所有变量线性组合的共同潜在维度。HEP与贫血标志物大多具有统计学意义的中到高度相关性（0.30 - 0.70，均P < 0.01），与铁代谢标志物及炎症标志物具有低相关性（r = 0.20 - 0.40，均P < 0.01），与红细胞生成标志物具有中度相关性。主成分分析揭示了两个潜在成分（因子），可解释约50%的总变异性。因子1主要由贫血、铁代谢和红细胞生成标志物组成，并与“红细胞健康状态”相关，而因子2主要由炎症和铁代谢标志物组成，并与“急性期反应物”相关。HEP是唯一在两个因子上均有显著载荷的变量。HEP与贫血、铁代谢、炎症及红细胞生成标志物相关。此外，当所有变量“缩减”为最少数量的两个“潜在”因子时，HEP在两者上均有载荷，因此突出了其在炎症性贫血和/或功能性缺铁红细胞生成反应复杂相互作用中的关键作用。
