Chen Sipei, Tang Yu, Pu Yangmei, Xia Xiaoqiang, Li Yi, Zou Yang
Department of Nephrology and Institute of Nephrology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Sichuan Clinical Research Centre for Kidney Diseases, Chengdu, Sichuan, China.
School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
Front Endocrinol (Lausanne). 2025 Jul 30;16:1503940. doi: 10.3389/fendo.2025.1503940. eCollection 2025.
Vascular calcification (VC) is a well-established risk factor for cardiovascular disease (CVD) and mortality in patients on maintenance hemodialysis (MHD). These patients frequently present with hyperphosphatemia as well as disorders of iron metabolism. This study aims to explore the role of ferritin heavy chain (FTH) in the development and progression of coronary artery calcification (CAC) in patients on MHD and assess its predictive value.
Using a bioinformatics approach, we analyzed datasets related to VC. In our prospective study, we evaluated the Coronary Artery Calcification Score (CACS) alongside clinical markers, including serum FTH, serum ferritin, and transferrin saturation (TSAT), in patients on MHD at baseline and after a 1-year follow-up.
Fth1 was identified as a differentially expressed gene significantly upregulated in the aorta of both ApoE mice (atherosclerotic calcification model) and chronic kidney disease (CKD) mice (medial calcification model). Among patients on MHD, 85.71% exhibited CAC, with 49.09% showing progression. Patients with CAC tended to be older and have a higher body mass index (BMI). Notably, serum FTH and phosphorus (P) levels were significantly elevated in those with progressive CAC. Elevated serum FTH and high serum P were both independent risk factors for CAC progression and showed predictive value.
Elevated serum FTH and high serum phosphorus are clinically significant predictors of VC progression in patients on MHD.
血管钙化（VC）是维持性血液透析（MHD）患者心血管疾病（CVD）和死亡的既定危险因素。这些患者常出现高磷血症以及铁代谢紊乱。本研究旨在探讨铁蛋白重链（FTH）在MHD患者冠状动脉钙化（CAC）发生和发展中的作用，并评估其预测价值。
我们采用生物信息学方法分析了与VC相关的数据集。在我们的前瞻性研究中，我们在基线和1年随访后，对MHD患者的冠状动脉钙化评分（CACS）以及包括血清FTH、血清铁蛋白和转铁蛋白饱和度（TSAT）在内的临床标志物进行了评估。
Fth1被鉴定为在载脂蛋白E小鼠（动脉粥样硬化钙化模型）和慢性肾脏病（CKD）小鼠（中膜钙化模型）的主动脉中均显著上调的差异表达基因。在MHD患者中，85.71%出现CAC，其中49.09%有进展。患有CAC的患者往往年龄较大且体重指数（BMI）较高。值得注意的是，进展性CAC患者的血清FTH和磷（P）水平显著升高。血清FTH升高和高血清P均为CAC进展的独立危险因素，并显示出预测价值。
血清FTH升高和高血清磷是MHD患者VC进展的临床重要预测指标。
