Serum hepcidin predicts uremic accelerated atherosclerosis in chronic hemodialysis patients with diabetic nephropathy.
Serum hepcidin predicts uremic accelerated atherosclerosis in chronic hemodialysis patients with diabetic nephropathy.
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DOI：
10.4103/0366-6999.156781
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发表时间：
2015-05-20
影响因子：
6.1
通讯作者：
Wang SX
中科院分区：
文献类型：
--
作者：
Li H;Feng SJ;Su LL;Wang W;Zhang XD;Wang SX
铁调素作为机体铁储备的调节剂，在慢性疾病贫血的发病机制中起着重要作用。动脉粥样硬化性心血管疾病是慢性血液透析（CHD）患者最常见的并发症和主要死亡原因。本研究旨在探讨冠心病合并糖尿病肾病（CHD/DN）患者血清hepcidin与尿毒症加速性动脉粥样硬化（UAAS）的关系。本研究共收集了78例CHD/DN和86例慢性血液透析的非糖尿病慢性肾小球肾炎（CHD/non-DN）患者。血清hepcidin-25的水平通过液相色谱-串联质谱法专门测量。采用酶联免疫吸附法测定血清白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNF-α）水平。CHD患者血清hepcidin-25水平明显升高。CHD/DN患者血清hepcidin-25水平显著高于CHD/非DN患者。CHD/DN患者血清hepcidin-25与铁蛋白、超敏C反应蛋白（hs-CRP）、TNF-α、IL-6呈正相关。CHD/DN组颈总动脉内膜中层厚度（CCA-IMT）、hs-CRP和hepcidin-25水平高于CHD/non-DN组。CHD/DN患者CCA-IMT与hepcidin、hs-CRP、LDL-C呈正相关。多元回归分析显示，CHD/DN患者血清hepcidin、hs-CRP水平与IMT独立相关。这些发现表明铁代谢和铁调素调节异常之间可能存在联系，可能有助于CHD/DN患者UAAS的发展。
Hepcidin, as a regulator of body iron stores, has been recently discovered to play a critical role in the pathogenesis of anemia of chronic disease. Atherosclerotic cardiovascular disease is the most common complication and the leading cause of death in chronic hemodialysis (CHD) patients. In the current study, we aimed to explore the relationship between serum hepcidin and uremic accelerated atherosclerosis (UAAS) in CHD patients with diabetic nephropathy (CHD/DN). A total of 78 CHD/DN and 86 chronic hemodialyzed nondiabetic patients with chronic glomerulonephritis (CHD/non-DN) were recruited in this study. The level of serum hepcidin-25 was specifically measured by liquid chromatography-tandem mass spectrometry. Serum levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were measured by enzyme-linked immunosorbent assay. High serum level of hepcidin-25 was seen in CHD patients. Serum hepcidin-25 in CHD/DN was significantly higher than that in CHD/non-DN patients. Serum hepcidin-25 was positively correlated with ferritin, high-sensitivity C-reactive protein (hs-CRP), TNF-α, and IL-6 in CHD/DN patients. CHD/DN patients exhibited higher common carotid artery intima media thickness (CCA-IMT), hs-CRP, and hepcidin-25 levels than that in CHD/non-DN patients. Moreover, in CHD/DN patients, CCA-IMT was positively correlated with serum hepcidin, hs-CRP, and low-density lipoprotein-cholesterol. On multiple regression analysis, serum hepcidin and hs-CRP level exhibited independent association with IMT in CHD/DN patients. These findings suggest possible linkage between iron metabolism and hepcidin modulation abnormalities that may contribute to the development of UAAS in CHD/DN patients.