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目的研究慢性肾脏病(CKD)5期患者血清铁调素水平与慢性肾脏病-矿物质和骨代谢紊乱(CKD-MBD)之间的相关性。方法选取2014年6至12月就诊于苏北人民医院及扬州市第一人民医院CKD5期患者228例,体检中心正常体检者40例作为对照组。采用酶联免疫吸附试验(ELISA)法检测血清铁调素浓度,并测定铁代谢指标:铁蛋白、血清铁、转铁蛋白饱和度;CKD-MBD相关指标:钙(Ca)、磷(P)、全段甲状旁腺激素(i PTH)及25-(OH)D;分析铁调素与铁代谢、CKD-MBD指标的相关性。结果与正常对照组比较,CKD5期患者血清中铁调素、i PTH和磷的水平明显升高,血清25-(OH)D水平明显降低,差异均有统计学意义(P<0.05)。相关分析结果显示,CKD5期患者血清铁调素和血清磷和i PTH水平呈正相关,有统计学意义(r=0.169,P=0.01;r=0.170,P=0.01)。但血清铁调素水平与血清钙及25-(OH)D并无相关性(r=0.073,P=0.269;r=0.111,P=0.094)。结论 CKD5期患者血清铁调素水平明显升高;铁调素可能参与钙磷代谢的调节;CKD-MBD与高铁调素水平密切相关。
Objective To investigate the correlation between serum hepcidin levels and CKD-MBD in patients with chronic kidney disease (CKD) stage 5. Methods A total of 228 patients with CKD stage 5 who visited the People’s Hospital of North Jiangsu and the First People’s Hospital of Yangzhou from June to December 2014 were selected as the control group. Serum hepcidin concentrations were measured by enzyme-linked immunosorbent assay (ELISA), and the iron metabolism parameters were determined: ferritin, serum iron, transferrin saturation; CKD-MBD related indicators: calcium, , Total parathyroid hormone (i PTH) and 25- (OH) D. The correlation between hepcidin and iron metabolism and CKD-MBD was analyzed. Results Compared with the control group, the level of hepcidin, i PTH and phosphorus in serum of patients with CKD5 were significantly increased, while the serum levels of 25- (OH) D were significantly decreased (P <0.05). Correlation analysis showed that there was a positive correlation between serum hepcidin and serum P and i PTH levels in patients with CKD5 (r = 0.169, P = 0.01; r = 0.170, P = 0.01). However, there was no correlation between serum hepcidin and serum calcium and 25- (OH) D (r = 0.073, P = 0.269; r = 0.111, P = 0.094). Conclusions Serum hepcidin levels are significantly elevated in patients with CKD5; hepcidin may be involved in the regulation of calcium and phosphorus metabolism; CKD-MBD is closely related to the level of high-iron.