血清铁调素与血液透析患者铁负荷及微炎症状态相关  

Serum hepcidin is associated with iron status and micro-inflammation in hemodialysis patients

作　　者：徐雁[1] 邹建洲[2] 刘中华[2] 蒋素华[2] 徐少伟[2] 沈波[2] 晋玮[2] 滕杰[2] 丁小强[2] 

机构地区：[1]同济大学附属同济医院肾内科,上海200065 [2]复旦大学附属中山医院肾内科血液净化中心

出　　处：《上海医学》2012年第3期242-246,共5页Shanghai Medical Journal

基　　金：教育部国家"211工程"重点学科建设项目(三期)资助(211XK20)

摘　　要：目的探讨维持性血液透析(MHD)患者血清铁调素水平与铁负荷及微炎症状态的关系。方法选取治疗6个月以上的稳定的MHD患者48例(MHD组),以体格检查健康人20名为健康对照组。采用酶联免疫吸附法(ELISA)测定血清铁调素和白细胞介素(IL)-6水平。采用Spearman相关和线性回归分析铁调素与其他指标的相关性。结果 MHD组患者血清铁调素水平为146.4～455.9μg/L,中位值为225.6μg/L,IL-6水平为35.0～97.2ng/L,中位值为48.0ng/L;健康对照组患者血清铁调素水平为54.5～171.5μg/L,中位值为90.4μg/L,IL-6水平为26.5～51.6ng/L,中位值为43.9ng/L。MHD组患者血清铁调素和IL-6水平均显著高于健康对照组(P值均<0.05)。Spearman相关分析显示,血清铁调素水平与铁蛋白(ρ=0.892)、转铁蛋白饱和度(ρ=0.289)及IL-6(ρ=0.439)水平呈正相关(P值均<0.05),与不饱和铁结合力(ρ=-0.570)、总铁结合力(ρ=-0.552)及转铁蛋白(ρ=-0.532)水平呈负相关(P值均<0.05)。线性回归分析显示,MHD患者血清铁蛋白(未标准化回归系数=0.761,标准化回归系数=0.736,P<0.001)及总铁结合力(未标准化回归系数=-5.654,标准化回归系数=-0.204,P=0.034)水平与铁调素水平独立相关。结论 MHD患者血清铁调素水平显著升高;血清铁调素水平与MHD患者铁负荷及微炎症状态相关;ELISA方法检测铁调素可以应用于临床,结合超敏C反应蛋白及铁代谢指标等指导肾性贫血中铁剂的应用。Objective To investigate the association of serum hepcidin, iron status and micro- inflammation in maintenance hemodialysis （MHD） patients. Methods Totally 48 MHD patients and 20 healthy subjects were enrolled in this study. Serum hepcidin and interleukin 6 （IL-6） levels were measured by enzymelinked immunosorbant assay （ELISA）. Spearman correlation and linear regression were used to assess the relationship between serum hepcidin levels and other laboratory parameters in MHD patients. Results Serum hepcidin and IL-6 levels were significantly higher in MHD patients than those in normal controls （225.6 [146.4- 455.91μg/L vs. 90.4 1-54.5-171.51 μg/L, P〈0.05〈 48 [35. 0- 97. 2] ng/L vs. 43.9 [26. 5- 51. 6] ng/L, P〈0.05）. Spearman correlation showed that serum hepcidin levels in MHD patients were positively correlated with ferritin （p = 0. 892）, transferrin saturation （TSAT, p = 0. 289） and IL-6 （p = 0. 439）, and negatively correlated with unsaturated iron-binding capacity （UIBC, p = - 0. 570）, total iron-binding capacity （TIBC, p = -0.552） and transferrin （p = - 0. 532）. Linear regression analysis showed that ferritin （non-standardized regression coefficient was 0. 761, standardized regression coefficient was 0. 736, P 〈 0. 001 ） and TIBC （nontandardized regression coefficient was - 5. 654, standardized regression coefficient was - 0. 204, P = 0. 034） were independently associated with serum hepcidin levels. Conclusion Serum hepcidin levels are markedly elevated and are associated with iron status and micro-inflammation in MHD patients. ELISA is an available method for the measurement of serum hepcidin in clinical practice. Serum hepcidin, high-sensitivity C-reactive protein （hsORP） and iron status are indicators of iron administration for anemia in MHD oatients. （Shanahai Med J, 2012,35： 242-246）

关 键 词：铁调素 血液透析 炎症 贫血 铁 

分 类 号：R459.5[医药卫生—治疗学]