Vitamin D status is associated with hepcidin and hemoglobin concentrations in patients with severe traumatic injury.
Vitamin D status is associated with hepcidin and hemoglobin concentrations in patients with severe traumatic injury.
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DOI：
10.1097/ta.0000000000002895
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发表时间：
2020-12
期刊：
影响因子：
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通讯作者：
Mohr AM
中科院分区：
文献类型：
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作者：
Apple CG;Miller ES;Kannan KB;Stortz JA;Cox M;Loftus TJ;Parvataneni HK;Patrick M;Hagen JE;Brakenridge S;Efron PA;Mohr AM
严重创伤导致持续性损伤相关性贫血，与高儿茶酚胺血症、全身性炎症、肝素升高和功能性缺铁有关。维生素D已被证明可以降低促炎细胞因子和海普西丁的浓度。本研究旨在研究维生素D状态与炎症、铁生物标志物和钝性创伤后贫血的关系。一项前瞻性观察队列研究，比较了钝性创伤患者(n=45)、择期髋关节置换术患者(n=22)和健康对照组(n=8)。用定量聚合酶链式反应检测骨髓铁蛋白、转铁蛋白受体和红细胞铁蛋白的表达。用酶联免疫吸附试验检测血浆中的全身炎症、促红细胞生成素、铁调节和维生素D(25-OH)浓度。在出院当天测定血红蛋白。与髋关节置换术患者相比，创伤患者的血浆白介素6(90.1比3.8 pg/m L)、C反应蛋白(6223比2612 ng/m l)和海普西丁(79.3比21.2 ng/m l)浓度更高。与髋关节置换术患者相比，创伤患者的维生素D(25-OH)(12.8vs.18.1 ng/mL)和铁(23.5ug/mLvs.59.9ug/ml)水平较低。尽管海普西丁促红细胞生成素水平较高，但创伤后骨髓红铁蛋白的表达增加了69%。在择期髋关节置换术后，患者确实有贫血和铁稳态受损，但炎症生物标记物、促红细胞生成素和维生素D状态没有明显变化。维生素D的状态确实与全身炎症、铁功能障碍和严重钝性创伤后持续的损伤相关性贫血有关。需要进一步的研究来确定在创伤人群中补充维生素D是否可以改善持续性损伤相关贫血。III级前瞻性研究，预测
Severe traumatic injury leads to persistent injury-associated anemia that is associated with hypercatecholaminemia, systemic inflammation, increased hepcidin and a functional iron deficiency. Vitamin D has been shown to reduce proinflammatory cytokines and hepcidin concentrations. This study aimed to investigate the association of vitamin D status with inflammation, iron biomarkers and anemia following blunt trauma. A prospective observational cohort study comparing blunt trauma patients (n=45) with elective hip replacement patients (n=22) and healthy controls (n=8). Bone marrow ferroportin, transferrin receptor and erythroferrone expression was measured using qPCR. Plasma was assessed for systemic inflammation, erythropoietin, iron regulation and vitamin D (25-OH) concentrations using ELISA. Hemoglobin was measured on the day of discharge. Compared with hip replacement, trauma patients had higher plasma interleukin-6 (90.1 vs. 3.8 pg/mL), C-reactive protein (6223 vs. 2612 ng/mL), and hepcidin (79.3 vs. 21.2 ng/mL) concentrations. Trauma patients had lower vitamin D (25-OH)(12.8 vs. 18.1 ng/mL) and iron (23.5 vs. 59.9 ug/mL) levels compared to hip replacement patients. Despite the higher hepcidin erythropoietin levels, bone marrow erythroferrone expression was increased 69% following trauma. Following elective hip replacement, patients did have anemia and impaired iron homeostasis without a significant change in inflammatory biomarkers, erythropoietin and vitamin D status. Vitamin D status did correlate with systemic inflammation, iron dysfunction, and persistent injury-associated anemia following severe blunt trauma. Further research is needed to determine whether supplementation with vitamin D in the trauma population could improve the persistent injury-associated anemia. Level III Prospective study, Prognostic