Proinflammatory state, hepcidin, and anemia in older persons
Proinflammatory state, hepcidin, and anemia in older persons
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DOI：
10.1182/blood-2009-02-201087
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发表时间：
2010-05-06
期刊：
影响因子：
20.3
通讯作者：
Longo, Dan L.
中科院分区：
文献类型：
--
作者：
Ferrucci, Luigi;Semba, Richard D.;Longo, Dan L.
在患有明显炎性疾病的患者中，上调的铁调素损害铁吸收和巨噬细胞释放，引起贫血。衰老的轻度促炎状态是否与铁调素增加有关尚不清楚。我们对582名65岁或以上的患者进行了InCHIANTI（Invecchiare in Chianti，“Aging in the Chianti Area”）研究，这是一项在意大利托斯卡纳进行的基于人群的衰老研究。与非贫血患者相比，缺铁性贫血和炎症性贫血患者的尿铁调素（纳克/毫克尿肌酐）显著低于非贫血或其他贫血类型。尿铁调素与log（铁蛋白）呈正相关，与可溶性转铁蛋白受体/log（铁蛋白）比值呈负相关，但与炎症标志物：白细胞介素-6（IL-6）、IL-1 β、肿瘤坏死因子-α和C-反应蛋白（CRP）不相关。较低的铁与较高的IL-6和CRP显着相关。调整混杂因素后，IL-6和CRP与血清铁显著相关，没有证据表明这种关系是由尿铁调素的变异性引起的。总之，促炎标志物升高与贫血和低铁状态相关，但与尿铁调素升高无关。未来的研究应该测试铁调素的产生是否只在明显炎症的情况下才上调。（血。2010; 115（18）：3810-3816）
patients with overt inflammatory diseases, up-regulated hepcidin impairs iron absorption and macrophage release, causing anemia. Whether the mild pro-inflammatory state of aging is associated with increased hepcidin is unknown. We characterized the relationships between urinary hepcidin, iron status, anemia, and inflammation in 582 patients 65 years or older participating in the InCHIANTI (Invecchiare in Chianti, "Aging in the Chianti Area") study, a population-based study of aging in Tuscany, Italy. Compared with nonanemic persons, urinary hepcidin (nanograms/milligram of urinary creatinine) was significantly lower in iron deficiency and inflammation anemia compared with no anemia or other anemia types. Urinary hepcidin was positively correlated with log(ferritin) and negatively correlated with the soluble transferrin receptor/log(ferritin) ratio but not correlated with markers of inflammation: interleukin-6 (IL-6), IL-1 beta, tumor necrosis factor-alpha, and C-reactive protein (CRP). Lower iron was significantly correlated with higher IL-6 and CRP. Adjusting for confounders, IL-6 and CRP remained significantly associated with serum iron, with no evidence that such a relationship was accounted for by variability in urinary hepcidin. In conclusion, elevated pro-inflammatory markers were associated with anemia and low iron status, but not with higher urinary hepcidin. Future studies should test whether hepcidin production becomes up-regulated only in situations of overt inflammation. (Blood. 2010; 115(18):3810-3816)