Hori Mayuko, Takahashi Hiroshi, Kondo Chika, Takeda Asami, Morozumi Kunio, Maruyama Shoichi
Department of Nephrology, Masuko Memorial Hospital, Nakamura-ku, Nagoya 453-8566, Aichi, Japan.
Department of Nephrology, Fujita Health University School of Medicine, Toyoake 470-1192, Aichi, Japan.
Nutrients. 2025 Jul 15;17(14):2323. doi: 10.3390/nu17142323.
Patients undergoing hemodialysis frequently receive oral or intravenous iron supplementation to treat iron-deficiency anemia and enhance the efficacy of erythropoiesis-stimulating agents. However, this approach may lead to iron overload. Experimental studies have suggested that iron overload may contribute to the development of sarcopenia through oxidative stress and inflammation. This study aimed to investigate the association between iron status and sarcopenia in patients undergoing hemodialysis. Serum ferritin levels were measured, and sarcopenia was assessed using the Asian Working Group for Sarcopenia criteria in 104 stable outpatients undergoing maintenance hemodialysis therapy. Sarcopenia was identified in 25 (24.0%) patients. Serum ferritin levels were significantly higher in patients with sarcopenia than in those without (median: 170.6 ng/mL vs. 92 ng/mL, = 0.023). An increase of 10 ng/mL in serum ferritin levels was independently associated with sarcopenia. The high-ferritin group (≥132 ng/mL as a cutoff value determined using receiver operating characteristic curve analysis) exhibited a higher prevalence of sarcopenia compared with the low-ferritin group (37.3% vs. 11.3%, = 0.001). Furthermore, serum ferritin levels were negatively correlated with skeletal muscle mass and skeletal muscle strength, which constitute the components of the sarcopenia diagnostic criteria. Elevated serum ferritin levels were independently associated with sarcopenia in patients undergoing hemodialysis. This finding implies that excessive iron supplementation may contribute to the progression of sarcopenia. Routine evaluation of iron status and careful assessment of the necessity for iron therapy are recommended in this population.
接受血液透析的患者经常接受口服或静脉补铁治疗缺铁性贫血，并提高促红细胞生成素的疗效。然而，这种方法可能会导致铁过载。实验研究表明，铁过载可能通过氧化应激和炎症促进肌肉减少症的发展。本研究旨在调查接受血液透析的患者铁状态与肌肉减少症之间的关联。测量了104例接受维持性血液透析治疗的稳定门诊患者的血清铁蛋白水平，并使用亚洲肌肉减少症工作组的标准评估了肌肉减少症。25例（24.0%）患者被诊断为肌肉减少症。肌肉减少症患者的血清铁蛋白水平显著高于无肌肉减少症的患者（中位数：170.6 ng/mL对92 ng/mL，P = 0.023）。血清铁蛋白水平每增加10 ng/mL与肌肉减少症独立相关。高铁蛋白组（使用受试者工作特征曲线分析确定的截断值≥132 ng/mL）与低铁蛋白组相比，肌肉减少症的患病率更高（37.3%对11.3%，P = 0.001）。此外，血清铁蛋白水平与构成肌肉减少症诊断标准的骨骼肌质量和骨骼肌力量呈负相关。血清铁蛋白水平升高与接受血液透析的患者的肌肉减少症独立相关。这一发现意味着过量补铁可能会促进肌肉减少症的进展。建议对该人群进行铁状态的常规评估，并仔细评估铁治疗的必要性。
