| 摘要: |
| ［摘要］ 目的 探讨血清铁调素（Hepcidin）在慢性肾脏病（chronic kidney disease,CKD）5期患者中的表达水平及与血清25羟维生素D［25(OH)D］的关系。方法 入选CKD 5期患者85例，其中维持性血液透析（MHD组）55例，非透析组30例；健康体检者30名为对照组。检测三组血清Hepcidin、25(OH)D水平；MHD组、非透析组同时测定血红蛋白、钙、磷、甲状旁腺素（PTH）、血清铁蛋白(SF)、血清铁（SI）、转铁蛋白饱和度（TSAT）、C反应蛋白(CRP)、血肌酐（Scr）等临床指标，分析Hepcidin与25(OH)D等指标的相互关系。结果 MHD组、非透析组、对照组Hepcidin水平分别是(91.8±11.3)μg/L、(58.9±5.27)μg/L、(46.9±5.95)μg/L；25(OH)D水平分别是(25.9±3.25)μg/L、(29.2±4.21)μg/L、(36.9±3.65)μg/L，组间比较，差异有统计学意义（P<0.05）。85例患者中，28例25(OH)D缺乏，32例25(OH)D不足，25例25(OH)D正常。与25(OH)D正常组相比，缺乏组血清Hepcidin、CRP及不足组的PTH明显升高，两组血红蛋白明显降低，差异有统计学意义（P<0.05）。相关性分析结果显示，CKD 5期患者血清Hepcidin水平与血红蛋白、SI、25(OH)D呈负相关（r=-0.436，P<0.01；r=-0.337，P<0.05；r=-0.578，P<0.05），与SF、CRP呈正相关（r=0.406，P<0.05；r=0.366，P<0.05），与血钙、磷、PTH、SCr、白蛋白无相关性（P>0.05）。多元线性回归分析Hepcidin与血红蛋白、CRP、SF相关（P<0.05）。结论 CKD 5期患者Hepcidin表达水平升高，尤以MHD组明显；Hepcidin的表达水平与贫血、炎症及铁负荷状态密切相关；25(OH)D缺乏或不足在CKD 5期患者较为常见，25(OH)D缺乏患者血Hepcidin升高，但多元线性回归分析并未显示与Hepcidin具有相关性。 |
| 关键词: 慢性肾脏病5期 铁调素 25羟维生素D |
| DOI：10.3969/j.issn.1674-3806.2017.10.04 |
| 分类号:R 692 |
| 基金项目:广西医疗卫生适宜技术研究与开发课题（编号：S201421-04） |
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| Serum hepcidin associated with vitamin D deficiency in patients with chronic kidney disease stage 5 |
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ZHONG Jian, ZHANG Wen-xin, TANG Sheng, et al
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Xianshuigu Hospital of Jinnan District, Tianjin 300350, China
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| Abstract: |
| ［Abstract］ Objective To investigate the expression of serum hepcidin and its relationship with 25 hydroxy vitamin D［25(OH)D］ in patients with chronic kidney disease(CKD) stage 5.Methods 85 patients with CKD stage 5 were enrolled, among whom 55 cases were treated with maintennance hemodialysis(MHD), and the other 30 cases received non-dialysis treatment. 30 healthy people were taken as the control group. The levels of serum hepcidin, 25(OH)D, hemoglobin(Hb), ferritin(SF), serum iron(SI), transferrin saturation(TSAT) and c-reactive protein(CRP) were detected and compared among the three groups.Results The levels of hepcidin in the MHD group, non-dialysis group and the control group were （91.8±11.3）μg/L, （58.9±5.27）μg/L and （46.9±5.95）μg/L respectively. The levels of 25(OH)D in the above three groups were （25.9±3.25）μg/L, （29.2±4.21）μg/L and （36.9±3.65）μg/L respectively. The level of hepcidin was significantly higher and the level of 25(OH)D was significantly lower in the MHD group than those in the non-dialysis group and the control group(P< 0.05). Of the 85 patients with CKD stage 5, 28 cases had a 25(OH)D deficiency and 32 cases had a 25(OH)D insuffciency. Compared with those in the normal group, the levels of hepcidin and CRP in the deficiency group were significantly higher, PTH in the insuffciency group was significantly higher, and hemoglobin was significantly lower in both of the two groups(P<0.05). Hepcidin was negatively correlated with Hb, SI and 25(OH)D but positively correlated with SF and CRP. Multiple stepwise regression showed that SF, CRP and Hb were closely related to hepcidin in the patients with CKD stage 5.Conclusion Hepcidin is elevated in the patients with CKD stage 5. Inflammation, iron storage and anemia affect the expression of hepcidin. Hepcidin is elevated in the patients with 25(OH)D deficiency, but is not associated with 25(OH)D. |
| Key words: Chronic kidney disease(CKD)stage 5 Hepcidin 25 hydroxy vitamin D［25(OH)D］ |
