| Objective: To investigate the expression changes of Erythroferrone(ERFE)and Hepcidin in patients with Chronic Kidney Disease(CKD)and their relationship with iron metabolism and clinical indexes Methods: A total of 78 patients with CKD were enrolled.According to the presence or absence of anemia,78 patients were divided into CKD anemia group 54cases(CKD1 3 cases,CKD2 5 cases,CKD3 7 cases,CKD4 13 cases,CKD5 26cases),Non-anemia group 24 cases(CKD1 14 cases;CKD2 6 cases;CKD3 4 cases;CKD4,CKD5 0 cases)and healthy control patients 7 cases.Enzyme-linked immunosorbent assay was used to detect the levels of ERFE and hepcidin.Meanwhile,blood routine,blood biochemical and iron metabolism indexes were collected.The differences of indexes in each group were compared and analyzed.All data were analyzed by SPSS 20.0,GraphPad software Treatment,P <0.05 for statistical differences.Results:(1)With the progression of CKD,the blood ERFE and Hepc25 tended to increase gradually.The levels of ERFE in CKD1,CKD2,CKD3,CKD4,CKD5,HD were: 0.51 ± 0.18(ng/ml),0.53 ± 0.22(ng/ml),0.75 ± 0.38(ng/ml),0.76 ±0.4(ng/ml),0.86 ± 0.37(ng/ml),0.89(0.5,1.02)(ng/ml),1.15 ± 0.75(ng/ml),blood Hepc25 respectively were:31.42 ± 20.69(ng/ml),35.32 ± 22.48(ng/ml),36.91 ±24.95(ng/ml),45.47 ± 51.3(ng/ml),57.7 ± 15.15(ng/ml),59.94 ± 15.1(ng/ml),101.81 ±33.5(ng/ml),(P <0.05);(2)The levels of ERFE(0.78±0.41)ng/mL and Hepc25(50.55±33.73)ng/m L in CKD anemia group were significantly higher than those in CKD non-anemia group [(0.78 ± 0.41)ng / mL;(36.43±19.19)ng/mL]and The Healthy Control Group [(0.51±0.18)ng/mL;(33.42±20.69)ng/mL],the difference was statistically significant(P <0.05).(3)The correlation analysis showed that the serum ERFE was positively correlated with Hepc-25,age and CKD stage,r were0.307,0.368,0.228,P <0.05,weak positive correlation with cr,and weakly negative correlation with eGFR,r respectively were 0.198,-0.207,P ? 0.05;serum Hepc-25 were positive correlations of ERFE,Fer,Cr,Urea,Cys-c,UA,PCT,iPTH and CKD stage,r were 0.307,0.262,0.235,0.24,0.284,0.253,0.365,0.238,0.39,P < 0.05,HGB?RBC,eGFR,LDL-C,TC were negative correlat with Hepc-25,r were-0.275,-0.246,-0.236,-0.287,-0.253,P <0.05.Multivariate stepwise regression analysis showed that age and ERFE were independently associated with ERFE in CKD(standard coefficients B were 0.517,0.412,P values were 0.005,0.02,respectively);multiple regression analysis using Hepcidin-25 as a dependent variable showed that FAM132 b was an indepente Factors of Hepc-25(5)Stratified analysis showed that in each subgroup of CKD1,CKD2 and CKD3,the Hepc25 of anemia patients was significantly higher than that of non-anemia patients,(P <0.05).ERFE in patients with anemia was also higher than that in non-anemia patients,but the difference was not significant(P> 0.05).With the increase of age,ERFE gradually increased,and the Age of patients over 35 years old,ERFE was significantly greater than patients under35 years of age(P <0.05),while Hepc25 had nothing to do with age.The application of EPO intravenously increased blood ERFE significantly(P <0.05);ERFE and Hepc25 did not seem to be related to the three iron states.With the aggravation of anemia,ERFE and Hepc25 tended to increase gradually.Hepc25 in HGB <100g / L group was significantly higher than that in healthy control group(P <0.05).Conclusions:(1)With the progress of CKD,Serum ERFE and Hepc25 gradually increased,and hemodialysis patients increased more significantly.(2)The level of serum ERFE was closely related to the renal function,serum Hepc25,EPO application,anemia and age.(3)The level of serum Hepc25 is closely related to the renal function,serum ERFE,iron status,inflammation,anemia and blood lipids.Detection of serum ERFE and hepcidin expression in patients with chronic kidney disease will provide more sensitive markers for the evaluation of iron status,providing a new target for the treatment of renal anemia. |
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