Bolignano Davide, Dounousi Evangelia, Presta Pierangela, Greco Marta, Duni Anila, Crugliano Giuseppina, Pappas Charalambos, Pappas Ethymios, Dragone Francesco, Lakkas Lampros, Foti Daniela Patrizia, Andreucci Michele, Coppolino Giuseppe
Nephrology and Dialysis Unit, Magna Graecia University, Catanzaro, Italy.
Department of Nephrology, University Hospital of Ioannina, Ioannina, Greece.
Clin Kidney J. 2021 Oct 13;15(2):303-310. doi: 10.1093/ckj/sfab189. eCollection 2022 Feb.
Iron deficiency is highly prevalent among patients undergoing chronic haemodialysis (HD) but its correct identification is often problematic as common biomarkers of iron status, such as transferrin saturation (TSAT) and ferritin, can be altered by inflammation or malnutrition.
In this pilot multicentre study, we aimed at evaluating circulating levels of Omentin-1, a novel fat depot-specific adipokine that is also involved in iron regulation, in a cohort of 85 chronic HD patients with relation to their iron status.
Omentin-1 levels in HD were statistically higher than in healthy controls (P = 0.03) and there was a significant, growing trend in all iron parameters across Omentin-1 tertiles (P < 0.001). Compared with patients with optimal iron status, Omentin-1 levels were lower in subjects categorized according to TSAT ≤20% or serum ferritin ≤200 μg/L (both P < 0.001) and even more reduced in 19 patients (22%) simultaneously displaying low levels of both markers (P < 0.001). In this latter group, Omentin-1 levels increased in parallel to all other iron markers after iron correction by i.v. supplementation. At multivariate regression analyses, ferritin (β = 0.71; P < 0.001) and TSAT (β = 0.32; P = 0.03) remained the sole independent predictors of Omentin-1 levels. This biomarker also showed a remarkable diagnostic capacity at receiver operating characteristic analyses in identifying iron-depleted HD patients according to a criterion of TSAT ≤20% [area under the curve (AUC) 0.827], ferritin ≤200 μg/L (AUC 0.863) or low levels of both parameters (AUC 0.907).
Findings obtained indicate that Omentin-1 is somewhat involved in iron balance regulation and might be a candidate biomarker for diagnosing and managing altered iron conditions in HD patients.
缺铁在接受慢性血液透析（HD）的患者中非常普遍，但由于铁状态的常见生物标志物，如转铁蛋白饱和度（TSAT）和铁蛋白，会受到炎症或营养不良的影响，其正确识别往往存在问题。
在这项多中心试点研究中，我们旨在评估85例慢性HD患者队列中网膜素-1（一种新型的脂肪储存特异性脂肪因子，也参与铁调节）的循环水平与其铁状态的关系。
HD患者的网膜素-1水平在统计学上高于健康对照组（P = 0.03），并且在网膜素-1三分位数的所有铁参数中存在显著的上升趋势（P < 0.001）。与铁状态最佳的患者相比，根据TSAT≤20%或血清铁蛋白≤200μg/L分类的受试者中，网膜素-1水平较低（均P < 0.001），在同时显示两种标志物水平低的19例患者（22%）中甚至更低（P < 0.001）。在后者组中，通过静脉补充铁纠正后，网膜素-1水平与所有其他铁标志物平行升高。在多变量回归分析中，铁蛋白（β = 0.71；P < 0.001）和TSAT（β = 0.32；P = 0.03）仍然是网膜素-1水平的唯一独立预测因子。在根据TSAT≤20%[曲线下面积（AUC）0.827]、铁蛋白≤200μg/L（AUC 0.863）或两种参数水平低（AUC 0.907）的标准识别缺铁HD患者的受试者工作特征分析中，这种生物标志物也显示出显著的诊断能力。
获得的研究结果表明，网膜素-1在一定程度上参与铁平衡调节，可能是诊断和管理HD患者铁状态改变的候选生物标志物。
