[1]马赛 左庆娟 和丽丽 张国瑞 郭艺芳.血清铁铁调素在心衰患者中的表达其心功能的相关性分析[J].心血管病学进展,2023,(6):566.[doi:10.16806/j.cnki.issn.1004-3934.202.06.019]
　MA Sai,ZUO Qing Juan,HE Lili,et al.The Correlation of Serum Iron and Hepcidin Levels with Cardiac Function?span>in Heart Failure Patients[J].Advances in Cardiovascular Diseases,2023,(6):566.[doi:10.16806/j.cnki.issn.1004-3934.202.06.019]
点击复制

血清铁铁调素在心衰患者中的表达其心功能的相关性分析()
分享到：

《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2023年6期
页码:
566
栏目:
论著
出版日期:
2023-06-25

文章信息/Info

Title:
The Correlation of Serum Iron and Hepcidin Levels with Cardiac Function?span>in Heart Failure Patients
作者:
马赛 左庆娟 和丽丽 张国瑞 郭艺芳
(河北省人民医院疼痛科,河北 石家庄 050051)
Author(s):
MA Sai;  ZUO Qing Juan;  HE Lili;  ZHANG Guorui;  GUO Yifang
(Department of Pain Management,Hebei General Hospital,Shijiazhuang 050051,Hebei,China)
关键词:
心力衰竭; 血清铁; 铁调素; 铁缺乏
Keywords:
Heart failure;  Serum iron;  Hepcidin;  Iron deficiency
DOI:
10.16806/j.cnki.issn.1004-3934.202.06.019
摘要:
目的 探讨血清铁铁调素在心力衰竭（HF）患者中的表达水平其心功能的相关性。方法 选取2020年11月2021年6月于河北省人民医院心内科住院治疗的非贫血HF患者为研究对象。根据患者左心室射血分数（EF），分为射血分数保留心力衰竭（HFpEF）组射血分数降心力衰竭（HFrEF）组，另选取同期因其他系统疾病住院治疗的非贫血患者为对照组。收集患者一般临床资料、空腹血液指标、心脏超声指标，检测血清铁和血清铁调素水平，评估组患者各临床指标和心功能指标的相关性，采用多因素logistic回归分析HFHF类的相关因素以血清铁和铁调素水平HF的相关性。结果 对照组血清铁铁调素最[血清铁4.30(2.61,6.79) mg/L；铁调素108.96±39.17）pg/mL]，HFpEF组次之[血清铁2.63 (1.67,3.85) mg/L；铁调素80.84±34.81）pg/mL]，HFrEF组最[血清铁1.44 (0.85,1.99) mg/L；铁调素62.75±21.79）pg/mL]（P＜0.05）。组患者中，血清铁铁调素N末端脑钠肽前体（NT-proBNP）负相关血清铁r=－0.525，P.001；铁调素r=－0.436，P.001），EF正相关血清铁r=0.563，P.001；铁调素r=0.374，P.001）。多因素logistic回归分析结果显示估算的肾小球率过率（eGFR）OR=0.902，95% CI 0.838～0.970，P=0.005血清铁OR=0.458，95% CI 0.279～0.754，P=0.002是HF的独立负相关因素，eGFR86.285 mL/（min·1.73 m2）及血清铁3.589 mg/L是有助于诊断HF的临界值。血清铁OR=0.303，95% CI 0.153～0.600，P=0.001是HF类的独立负相关因素，血清铁2.083 5 mg/L是有助于诊断HF类的临界值。结论 血清铁铁调素在HF患者血清中表达水平降，HFrEF患者更显著。血清铁是HFHF类的独立负相关因素。
Abstract:
Objective To detect serum iron and hepcidin levels in patients with heart failure (HF) and analyze their correlations with cardiac function. Methods The non-anemic patients with HF hospitalized in Department of Cardiology,Hebei General Hospital from November 2020 to June 2021 were selected as research objects,and divided into HF with preserved ejection fraction (HFpEF) and reduced ejection fraction (HFrEF) groups. Non-anemic patients contemporarily hospitalized for other systemic diseases were assigned as control group. We collected the general clinical data,fasting blood indexes,cardiac ultrasound indexes and detected serum iron and hepcidin levels. The correlation between clinical indicators and cardiac function indicators was evaluated. HF and HF type associated factors,the correlation of serum iron and hepcidin with HF were analyzed by multivariate logistic regression. Results Serum iron and hepcidin levels were the highest in control group [serum iron 4.30 (2.61,6.79) mg/L,hepcidin (108.96?39.17) pg/mL],followed by HFpEF group [serum iron 2.63 (1.67,3.85) mg/L,hepcidin (80.84?34.81) pg/mL],and the lowest in HFrEF group [serum iron 1.44 (0.85,1.99) mg/L,hepcidin (62.75?21.79) pg/mL] (P＜0.05). Serum iron and hepcidin levels were negatively correlated with NT-proBNP [serum iron (r=－0.525P＜0.001),hepcidin (r=－0.436P＜0.001)],and positively correlated with ejection fraction [serum iron (r=0.563,P＜0.001),hepcidin (r=0.374,P＜0.001)]. Multivariate logistic regression analysis showed estimated glomerular filtration rate (eGFR) (OR=0.902,95% CI 0.838～0.970,P=0.005) and serum iron (OR=0.458,95% CI 0.279～0.754P=0.002) were the independently negative correlation factors for HF. The eGFR of 86.285 mL/(min·1.73m2) and serum iron concentration of 3.589 mg/L were considered as critical value for the diagnosis of HF. Serum iron (OR=0.303,95% CI 0.153～0.600P=0.001) was an independently negative correlation factor for HF types. The serum iron concentration of 2.0835 mg/L was considered as critical value for the diagnosis of HF types. Conclusion The expression levels of serum iron and serum hepcidin were decreased in HF patients,especially in HFrEF patients. Serum iron was an independently negative correlation factor for HF and HF types

参考文献/References:

[1].Ponikowski PVoors AA,Anker SD,et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure:the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC[J]. Eur J Heart Fail,2016,18(8):891-975.
[2].Swedberg K,Young JB,Anand IS,et al. Treatment of anemia with darbepoetin alfa in systolic heart failure[J]. N Engl J Med,2013,368(13):1210-1219.
[3].Terrovitis JV,Kaldara E,Ntalianis A,et al. Intravenous iron alone is equally effective with the combination of iron and rythropoietin for the treatment of irondeficiency anemia in advanced heart failure[J]. J Am Coll Cardiol,2012,60(21):2255-2256.
[4].Sharma SK,Agarwal SK,Bhargava K,et al. Prevalence and spectrum of iron deficiency in heart failure patients in south Rajasthan[J]. Indian Heart J,2016,68(4):493-497.
[5].Comin-Colet J,Lainscak M,Dickstein K,et al. The effect of intravenous ferric carboxymaltose on health-related quality of life in patients with chronic heart failure and iron deficiency:a subanalysis of the FAIR-HF study[J]. Eur Heart J,2013,34(1):30-38.
[6].Kell DB. Iron behaving badly:inappropriate iron chelation as a major contributor to the aetiology of vascular and other progressive inflammatory and degenerative diseases[J]. BMC Med Genomics,2009,2:2.
[7].Nemeth E,Tuttl MS,Powelson J,et al. Hepcidin regulates cellular iron efflux by binding to ferroportin and inducing its internalization[J]. Science,2004,306(5704):2090-2093.
[8].Nemeth E,Ganz T. The role of hepcidin in iron metabolism[J]. Acta Haematol,2009,122(2-3):78-86.
[9].中华医学会心血管病学分会心力衰竭学组中国医师协会心力衰竭专业委员会中华心血管病杂志编辑委员会. 中国心力衰竭诊断和治疗指南2018[J]. 中华心血管病杂志2018,46(10):760-789.
[10].Mei Z,Cogswell ME,Parvanta I,et al. Hemoglobin and ferritin are currently the most efficient indicators of population response to iron interventions:an analysis of nine randomized controlled trials[J]. J Nutr,2005,135(8):1974-1980.
[11].Pasricha SR,Flecknoe-Brown SC,Allen KJ,et al. Diagnosis and management of iron deficiency anaemia:a clinical update[J]. Med J Aust,2010,193(9):525-532.
[12].Pasricha SR,Mcquilten Z,Westerman W,et al. Serum hepcidin as a diagnostic test of iron deficiency in premenopausal female blood donors[J]. Haematologica,2011,96(8):1099-1105.
[13].Ponikowski P,van Veldhuisen DJ,Comin-Colet J,et al. Beneficial effects of long-term intravenous iron therapy with ferric carboxymaltose in patients with symptomatic heart failure and iron deficiency[J]. Eur Heart J,2015,36(11):657-668.
[14].Nú?ez J,Domínguez E,Ramón JM,et al. Iron deficiency and functional capacity in patients with advanced heart failure with preserved ejection fraction[J]. Int J Cardiol,2016,207:365-367.
[15].Kasner M,Aleksandrov AS,Westermann D,et al. Functional iron deficiency and diastolic function in heart failure with preserved ejection fraction[J]. Int J Cardiol,2013,168(5):4652-4657.
[16].Preiss D,Campbell RT,Murray HM,et al. The effect of statin therapy on heart failure events:a collaborative meta-analysis of unpublished data from major randomized trials[J]. Eur Heart J,2015,36(24):1536-1546.
[17].Smilde TDJ,Hillege HL,Navis G,et al. Impaired renal function in patients with ischemic and nonischemic chronic heart failure:association with neurohormonal activation and survival[J]. Am Heart J,2004,148(1):165-172.
[18].Nanas JN,Matsouka C,Karageorgopoulos D,et al. Etiology of anemia in patients with advanced heart failure[J]. J Am Coll Cardiol,2006,48(12):2485-2489.
[19].Elkammash A,Farahat RM,Al Sattouf A,et al. Iron deficiency in heart failure: what do we know so far[J]? Cureus,2022,14(10):e30348.
[20].McDonagh T,Macdougall IC. Iron therapy for the treatment of iron deficiency in chronic heart failure:intravenous or oral[J]? Eur J Heart Fail,2015,17(3):248-262.
[21].Jankowska EA,Malyszko J,Ardehali H,et al. Iron status in patients with chronic heart failure[J]. Eur Heart J,2013,34(11):827-834.
[22].Simonis G,Mueller K,Schwarz P,et al. The iron-regulatory peptide hepcidin is upregulated in the ischemic and in the remote myocardium after myocardial infarction[J]. Peptides,2010,31(9):1786-1790.
[23].Weinmann K,Werner J,Rottbauer W,et al. Immunoadsorption for heart failure is associated with normalization of iron metabolism[J]. Biomarkers,2021,26(5):395-400.
[24].Sai Ma,Lili He,Guorui Zhang,et al. Canagliflozin mitigates ferroptosis and ameliorates heart failure in rats with preserved ejection fraction[J].?Naunyn Schmiedebergs Arch Pharmacol,2022,395(8):945-962.
[25].Anker SD,Kirwan BA,van Veldhuisen DJ,et al. Effects of ferric carboxymaltose on hospitalisations and mortality rates in irondeficient heart failure patients:an individual patient data meta-analysis[J]. Eur J Heart Fail,2018,20(1):125-133.
[26].Ponikowski P,Kirwan BA,Anker SD,et al. Ferric carboxymaltose for iron deficiency at discharge after acute heart failure:a multicentre,double-blind,randomised,controlled trial[J]. Lancet,2020,396(10266):1895-1904.
[27].von Haehling S,Ebner N,Evertz R,et al. Iron deficiency in heart failure:an overview[J]. JACC Heart Fail,2019,7(1):36-46.

相似文献/References:

[1]丁娟,刘地川.心力衰竭与线粒体功能障碍的研究进展[J].心血管病学进展,2016,(1):84.[doi:10.16806/j.cnki.issn.1004-3934.2016.01.022]
　DING Juan,LIU Dichuan.Research Progress of Heart Failure and Mitochondrial Dysfunction[J].Advances in Cardiovascular Diseases,2016,(6):84.[doi:10.16806/j.cnki.issn.1004-3934.2016.01.022]
[2]罗秀林,综述,张烁,等.肾动脉去交感神经术治疗心力衰竭——希望还是炒作[J].心血管病学进展,2016,(3):268.[doi:10.16806/j.cnki.issn.1004-3934.2016.03.013]
　LUO Xiulin,ZHANG Shuo.Renal Sympathetic Denervation for Heart Failure—Hopes or Hypes[J].Advances in Cardiovascular Diseases,2016,(6):268.[doi:10.16806/j.cnki.issn.1004-3934.2016.03.013]
[3]查凤艳,综述,覃数,等.心源性恶病质发病机制的研究进展[J].心血管病学进展,2016,(3):282.[doi:10.16806/j.cnki.issn.1004-3934.2016.03.017]
　ZHA Fengyan,QIN Shu.Advances in Pathogenesis of Cardiac Cachexia[J].Advances in Cardiovascular Diseases,2016,(6):282.[doi:10.16806/j.cnki.issn.1004-3934.2016.03.017]
[4]李慧,综述,齐国先,等.老年射血分数保留的心功能不全研究进展[J].心血管病学进展,2016,(4):354.[doi:10.16806/j.cnki.issn.1004-3934.2016.04.007]
　LI Hui,QI Guoxian.Research Progress of Heart Failure with Preserved Ejection Fraction in Elderly People[J].Advances in Cardiovascular Diseases,2016,(6):354.[doi:10.16806/j.cnki.issn.1004-3934.2016.04.007]
[5]亢玉,综述,张庆,等.二尖瓣瓣叶在功能性二尖瓣反流发生机制中的角色[J].心血管病学进展,2016,(4):376.[doi:10.16806/j.cnki.issn.1004-3934.2016.04.013]
　KANG Yu,ZHANG Qing.Role of Mitral Leaflets in Pathogenesis of Functional Mitral Regurgitation[J].Advances in Cardiovascular Diseases,2016,(6):376.[doi:10.16806/j.cnki.issn.1004-3934.2016.04.013]
[6]史秀莉,张庆,喻鹏铭.心力衰竭患者运动训练方式及其疗效的研究进展[J].心血管病学进展,2015,(5):535.[doi:10.3969/j.issn.1004-3934.2015.05.003]
　SHI Xiuli,ZHANG Qing,YU Pengming.Exercise Training Modalities and Their Treatment Effects on Patients with Heart Failure[J].Advances in Cardiovascular Diseases,2015,(6):535.[doi:10.3969/j.issn.1004-3934.2015.05.003]
[7]熊卓超,陈康玉,严激.无创血流动力学评价在心力衰竭中的应用进展[J].心血管病学进展,2019,(6):923.[doi:10.16806/j.cnki.issn.1004-3934.2019.06.021]
　XIONG Zhuochao,CHEN Kangyu,YAN Ji.Application Progress of Noninvasive Hemodynamic Evaluation in Heart Failure[J].Advances in Cardiovascular Diseases,2019,(6):923.[doi:10.16806/j.cnki.issn.1004-3934.2019.06.021]
[8]高薇 陈伟.铁过载性心肌病[J].心血管病学进展,2019,(5):680.[doi:10.16806/j.cnki.issn.1004-3934.2019.05.006]
　GAO WeiCHEN Wei.Iron Overload Cardiomyopathy[J].Advances in Cardiovascular Diseases,2019,(6):680.[doi:10.16806/j.cnki.issn.1004-3934.2019.05.006]
[9]何燕 刘育.C型利钠肽与心力衰竭[J].心血管病学进展,2019,(5):745.[doi:10.16806/j.cnki.issn.1004-3934.2019.05.020]
　HE Yan,LIU Yu.C-type Natriuretic Peptide and Heart Failure[J].Advances in Cardiovascular Diseases,2019,(6):745.[doi:10.16806/j.cnki.issn.1004-3934.2019.05.020]
[10]吴彤 高东来.心房颤动合并心力衰竭的射频消融治疗[J].心血管病学进展,2019,(5):757.[doi:10.16806/j.cnki.issn.1004-3934.2019.05.023]
　WU TongGAO Donglai.Catheter Ablation of Atrial Fibrillation in Patients with Heart Failure[J].Advances in Cardiovascular Diseases,2019,(6):757.[doi:10.16806/j.cnki.issn.1004-3934.2019.05.023]

备注/Memo

备注/Memo:
收稿日期：2022-11-18基金项目：河北省重点研发计划(19277787D); 河北省创新能力提升计划(199776249D)
更新日期/Last Update: 2023-07-21