Department of Nephrology, Qilu Hospital of Shandong University (Qingdao), Qingdao, Shandong, China.
Qilu Hospital of Shandong University, Jinan, Shandong, China.
Medicine (Baltimore). 2023 Apr 25;102(17):e33558. doi: 10.1097/MD.0000000000033558.
Hepcidin is an essential regulator of iron homeostasis in chronic kidney disease (CKD) anemia, reticulocyte hemoglobin equivalent (RET-He) can be used to evaluate the availability of iron for erythropoiesis. Previous research has found that hepcidin indirectly regulates RET-He. This study aimed to investigate the association of hepcidin, RET-He and anemia-related indicators on anemia in chronic kidney disease. A total of 230 individuals were recruited, including 40 CKD3-4 patients, 70 CKD5 patients without renal replacement therapy, 50 peritoneal dialysis patients, and 70 hemodialysis patients. The serum levels of hemoglobin (Hb), reticulocyte, RET-He, serum iron, serum creatinine, serum ferritin, total iron binding capacity, hepcidin-25, high sensitivity C-reactive protein, transferrin, erythropoietin, intrinsic factor antibody, soluble transferrin receptor and interleukins-6 (IL-6) were measured. Hepcidin-25 was positively associated with IL-6, and negatively with total iron binding capacity, intrinsic factor antibody, and transferrin. Reticulocyte Hb equivalent was associated positively with Hb, serum ferritin, serum iron, transferrin saturation, and negatively with serum creatinine, reticulocyte, IL-6, STfR. Hepcidin-25 was not associated with RET-He, while IL-6 was independently associated with hepcidin-25 and RET-He, suggesting that hepcidin has no effffect on the iron dynamics of reticulocytes in CKD, may be related to IL-6, indicate a likelihood of a threshold for stimulation of hepcidin-25 expression by IL-6 in order to indirectly regulates RET-He.
铁调素是慢性肾脏病 (CKD) 贫血中铁稳态的重要调节剂,网织红细胞血红蛋白当量 (RET-He) 可用于评估铁对红细胞生成的可用性。先前的研究发现铁调素间接调节 RET-He。本研究旨在探讨铁调素、RET-He 和与贫血相关的指标与慢性肾脏病贫血之间的关系。共招募了 230 人,包括 40 名 CKD3-4 患者、70 名未接受肾替代治疗的 CKD5 患者、50 名腹膜透析患者和 70 名血液透析患者。测量了血红蛋白 (Hb)、网织红细胞、RET-He、血清铁、血清肌酐、血清铁蛋白、总铁结合力、铁调素-25、高敏 C 反应蛋白、转铁蛋白、促红细胞生成素、内因子抗体、可溶性转铁蛋白受体和白细胞介素-6 (IL-6) 的血清水平。铁调素-25 与 IL-6 呈正相关,与总铁结合力、内因子抗体和转铁蛋白呈负相关。网织红细胞 Hb 当量与 Hb、血清铁蛋白、血清铁、转铁蛋白饱和度呈正相关,与血清肌酐、网织红细胞、IL-6、STfR 呈负相关。铁调素-25 与 RET-He 无关,而 IL-6 与铁调素-25 和 RET-He 独立相关,表明铁调素对 CKD 网织红细胞的铁动力学没有影响,可能与 IL-6 有关,提示 IL-6 刺激铁调素-25 表达存在阈值的可能性,以间接调节 RET-He。
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