Serum Hepcidin: A Direct Link Between Anemia of Inflammation and Coronary Artery Atherosclerosis in Patients with Rheumatoid Arthritis
Serum Hepcidin: A Direct Link Between Anemia of Inflammation and Coronary Artery Atherosclerosis in Patients with Rheumatoid Arthritis
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DOI：
10.3899/jrheum.110339
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发表时间：
2011-10-01
影响因子：
3.9
通讯作者：
Ghobashi, Abeer Saeed
中科院分区：
文献类型：
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作者：
Abdel-Khalek, Manal Aly;El-Barbary, Amal Mohamad;Ghobashi, Abeer Saeed
Objective.探讨铁调素作为类风湿关节炎（RA）患者炎症性贫血诱导剂的作用及其与冠状动脉粥样硬化的关系。我们的研究包括60例RA患者和20例健康对照。将血清转铁蛋白受体/log铁蛋白（sTfR-F）指数< 1.5的RA患者归类为单纯慢性病贫血（ACD），sTfR-F指数> 1.5的RA患者归类为慢性病贫血合并缺铁性贫血（ACD+IDA）。测量28个关节的疾病活动性评分（DAS 28）、改良健康评估问卷（MHAQ）、红细胞沉降率（ESR）、高敏C反应蛋白（hsCRP）、类风湿因子（RF）、血脂、血清白细胞介素6（IL-6）、肿瘤坏死因子-α、铁研究和血清铁调素。使用多层螺旋计算机断层扫描测量冠状动脉钙评分（CCS）作为动脉粥样硬化的标志物。结果。发现RA贫血患者的血清铁调素高于对照组（p < 0.001），纯ACD亚组高于ACD+IDA亚组（p < 0.001）。Hepcidin浓度与病程、ESR、hsCRP、RF、DA 528、MHAQ、血清铁蛋白、IL-6和平均CCS呈正相关，与血红蛋白、sTfR和sTfR-F指数呈负相关。铁调素可被认为是RA患者贫血或炎症的关键诱导剂。这种炎症被证明与冠状动脉粥样硬化直接相关。血清铁调素与疾病活动性和IL-6之间的相关性提高了将其用作疾病活动性的替代标志物的可能性。（2011年9月1日首次发布; J Rheumol 2011;38：2153-9; doi：10.3899/jrheum.110339）
Objective. To investigate the role of hepcidin as an inducer of anemia of inflammation in patients with rheumatoid arthritis (RA), and its correlation to coronary artery atherosclerosis.Methods. Our study included 60 patients with RA and 20 healthy controls. Anemic RA patients with serum transferrin receptors/log ferritin (sTfR-F) index value < 1.5 were classified as having pure anemia of chronic disease (ACD), and patients with sTfR-F index value > 1.5 were classified as having anemia of chronic disease with coexistent iron deficiency anemia (ACD+IDA). Measurements were taken for Disease Activity Score for 28 joints (DAS28), Modified Health Assessment Questionnaire (MHAQ), erythrocyte sedimentation rate (ESR), high sensitivity C-reactive protein (hsCRP), rheumatoid factor (RF), lipid profile, serum interleukin 6 (IL-6), tumor necrosis factor-alpha, iron studies, and serum hepcidin. Coronary calcium score (CCS) was measured using multislice spiral computed tomography as a marker of atherosclerosis.Results. Serum hepcidin was found to be higher in anemic patients with RA than in controls (p < 0.001), and higher in the pure ACD subgroup than in the ACD+IDA subgroup (p < 0.001). Hepcidin concentration was positively correlated with disease duration, ESR, hsCRP, RF, DA528, MHAQ, serum ferritin, IL-6, and mean CCS and inversely correlated with hemoglobin, sTfR, and the sTfR-F index.Conclusion. Hepcidin can be considered a key inducer of anemia of inflammation in patients with RA. This inflammation was proved to be directly linked to coronary artery atherosclerosis. The correlations between serum hepcidin with disease activity and IL-6 raise the possibility of using it as a surrogate marker for disease activity. (First Release Sept 1 2011; J Rheumatol 2011;38:2153-9; doi:10.3899/jrheum.110339)