腹膜透析患者血清维生素D_3与铁调素及铁代谢的相关性研究

The study on the correlation between 25-hydroxy vitamin D^3 and iron metabolism in peritoneal dialysis patients

目的研究持续不卧床腹膜透析(continuous ambulatory peritoneal dialysis,CAPD)患者血清25-羟基维生素D_3[25(OH)D_3]与铁代谢的状态及铁调素(hepcidin)之间的关系。方法选取哈尔滨医科大学附属第二医院腹膜透析门诊病情稳定且接受1年以上的CAPD治疗的患者50例,体检中心30例健康者作为对照组。采用酶联免疫吸附法测定血清25(OH)D_3及Hepcidin的水平,同时检测受试者的血红蛋白(hemoglobin,Hb)、血生化、血清铁、铁蛋白(ferritin,Fer)、总铁结合力(total iron binding capacity,TIBC)。Pearson法分析25(OH)D_3与其他临床指标的相关性。结果与对照组相比,CAPD组患者25(OH)D_3(t=1.947,P=0.029)、Hb(t=6.676,P<0.001)及血清铁(t=8.463,P<0.001)、TICB(t=6.173,P<0.001)明显下降,Fer明显升高(t=3.084,P=0.003)组间比较差异具有统计学意义;Hepcidin高于健康对照组,但不具有统计学意义(t=1.280,P=0.204);血肌酐(t=22.810,P<0.001)、尿素氮(t=16.580,P<0.001)、磷(t=3.372,P<0.001)及甲状旁腺激素(t=8.010,P<0.001)升高,组间比较差异具有统计学意义。Pearson相关分析结果显示,CAPD组血清25(OH)D_3水平与Hepcidin成负相关(r=-0.382,P=0.003)。结论 CAPD患者血清25(OH)D_3水平的降低与机体的铁代谢异常及贫血有关。

Objective To study the correlation between 25-hydroxy vitamin D3 and the status of iron me-tabolism in patients with continuous ambulatory peritoneal dialysis （CAPD）. Methods A total of 50 patients treated with CAPD for more than one year with a stable disease condition in the Peritoneal Dialysis Clinic of this hospital were enrolled in this study （CAPD group）. A total of 30 healthy subjects from the Health Check-up Center were selected as the control group. Serum 25-hydroxy vitamin D3 and hepcidin were measured by enzyme-linked immunosorbent assay （ELISA）. Hemoglobin （HB）, blood biochemistry, serum iron, ferritin （Fer） and total iron binding capacity （TIBC） were assay by routine laboratory methods. Pearson correlation analysis was used to analyze the correlation between serum 25-hydroxy vitamin D3 and clinic indices. Re-sults As compared with control group, CAPD group had significantly lower serum 25-hydroxy vitamin D3 （t=1.947, P=0.029）, HB （t=6.676, P〈0.001）, iron （t=8.463, P〈0.001） and TIBC （t=6.173, P〈0.001）, signifi-cantly higher serum Fer （t=3.084, P=0.003）, higher hepcidin but without statistical significance （t=1.280, P=0.204）, and significantly higher serum creatinine （t=22.810, P〈0.001）, blood urea nitrogen （t=16.580, P〈0.001）, phosphorus （t=3.372, P〈0.001） and parathyroid hormone （t=8.010, P〈0.001）. Pearson correlation analysis revealed that serum 25-hydroxy vitamin D3 was negative correlated with hepcidin （r=-0.382, P=0.003）. Conclusion The lower level of serum 25-hydroxy vitamin D3 is associated with the abnormal iron metabolism and anemia in CAPD patients.