The Levels And Clinical Significance Of Serum Hepcidin In Patients With Maintenance Hemodialysis

Objective:To study the levels and clinical significance of surum Hepcidin in patients withMaintenance Hemodialysis（MHD）.Methods:The experiment was divided into three groups: MHD group (49cases),CAPD group(14cases), CRF group(24cases).The patients of MHD were divided into differentsubgroup according to the intima-media thickness(IMT) and ferritin:20patients withplaque(IMT≥1.3mm) and29patients with non-plaque（IMT＜1.3mm);23patients withhigh ferritin subgroup (ferritin≥170ng/ml) and26patients with low ferritin subgroup(ferritin <170ng/ml).Using enzyme-linked immunosorbent assay (ELISA) measured theserum Hepcidin levels and MCP-1levels of all the patients, while collecting all thepatient’s clinical data and laboratory parameters.Results:1. Serum Hepcidin levels in MHD group is topmost, following by the the CAPDgroup,the CRF group is lowest. The differences between groups was statisticallysignificant (P<0.001).2. Serum Hepcidin levels were positively correlated with hsCRP in all three group,respectively. hsCRP was the independent predictors of serum Hepcidin levels of MHDgroup and CAPD group (β=0.42, P <0.001; β=0.91, P <0.001,respectively).3. Serum Hepcidin levels were negatively correlated with GFR in the CRF group(r=-0.93, p <0.001),GFR was the only independent predictor of the serum Hepcidin levels ofCRF group(β=-0.80, p <0.001).4. Serum Hepcidin levels were negatively correlated with hematocrit, red blood cells,hemoglobin, and positively correlated with MCP-1, ferritin, PTH in all the three groups, respectively.5. Serum Hepcidin, MCP-1, ferritin levels of plaque subgroup were significantlyhigher than the non-plaque subgroup (P <0.05; P <0.001; P <0.05,respectively).6. Serum Hepcidin（β=0.09，P＜0.01），ferritin（β=0.05，P＜0.01）,MCP-1(β=0.07, P <0.05) levels were the influencing factors of atherosclerotic plaque.7. Serum Hepcidin levels of MHD group were not correlated with the risk factors ofatherosclerotic, such as blood pressure, cholesterol, triglyceride.8. The ratio of plaque of high ferritin subgroup,high Hepcidin and high MCP-1subgrou significantly higher than the low ferritin subgroup,low Hepcidin and low MCP-1subgroup,respectively(P<0.005).9. Serum Hepcidin levels and ferritin levels of the anemia subgroup were higher thannon-anemia subgroup(P=0.02; P <0.01).Conclusions:Serum Hepcidin levels in MHD group was topmost, following by the the CAPD group, theCRF group was lowest. Serum Hepcidin levels were negatively correlated with hematocrit,red blood cells, hemoglobin, and positively correlated with MCP-1, ferritin, PTH in all thethree groups, respectively; The ratio of plaque of high ferritin subgroup, high Hepcidinhigh MCP-1subgroup significantly higher than the low ferritin subgroup, low Hepcidinlow MCP-1subgroup, respectively, suggesting that Hepcidin may be involved in theprocess of atherosclerosis to the development of pathophysiology and Hepcidin associatedwith anemia.