铁调素在妊娠期缺铁性贫血中的表达及其与铁代谢参数的相关性

Expression of hepcidin in iron deficiency anemia during pregnancy and its correlation with iron metabolic parameters

目的观察铁调素在不同程度缺铁性贫血孕妇中的表达水平,探讨铁调素与红细胞参数、铁代谢参数、促红细胞生成素(erythropoietin,EPO)及炎性指标C反应蛋白(C-reactive protein,CRP)之间的关系,进一步阐明铁调素在妊娠期妇女缺铁性贫血中的调节机制。方法选取定期产检的孕妇和体检的健康未孕妇女共80例,分为健康对照组、孕妇正常组、孕妇轻度贫血组和孕妇中度贫血组。空腹采集血样,应用血细胞分析仪LH750检测血常规,采用酶联免疫吸附测定法检测血清中铁调素、EPO、血清铁蛋白(serum ferritin,SF)、血清转铁蛋白(serum transferrin,TRF),采用分光光度法检测血清铁(serum iron,SI)、总铁结合力(total iron binding force,TIBC),采用免疫比浊法检测CRP。结果与健康对照组比较,孕妇正常组、孕妇轻度贫血组和孕妇中度贫血组外周血红蛋白(hemoglobin,Hb)、红细胞压积(hematocrit,Hct)、SI和铁调素均降低,CRP均升高(P<0.05);与健康对照组比较,孕妇轻度贫血组和孕妇中度贫血组红细胞平均体积(mean corpuscular volume,MCV)、红细胞平均血红蛋白含量(mean corpuscular hemogolobin,MCH)和红细胞平均血红蛋白浓度(mean corpuscular hemogolobin concentration,MCHC)均降低,TIBC均升高(P<0.05);与健康对照组比较,孕妇中度贫血组EPO升高(P<0.05)。与孕妇正常组比较,孕妇轻度贫血组和孕妇中度贫血组Hb、Hct、MCV、MCH、MCHC、SI和铁调素均降低,TIBC均升高(P<0.05);与孕妇正常组比较,孕妇中度贫血组EPO和CRP均升高(P<0.05)。与孕妇轻度贫血组比较,孕妇中度贫血组Hb、Hct、MCV、MCH、SI均降低,TIBC和EPO均升高(P<0.05)。铁调素与Hb、Hct、MCV、MCH、MCHC、SI均呈正相关,与TIBC、EPO均呈负相关(P<0.05)。结论妊娠期缺铁性贫血与铁调素表达水平的下调有关,可能是通过EPO抑制发挥作用。

Objective To explore the relationship between hepcidin and red blood cell parameters,iron parameters,erythropoietin(EPO)and the inflammatory markers C-reactive protein by observing the expression level of hepcidin in pregnant women with different degrees of iron deficiency anemia and to further elucidate the regulation mechanism of hepcidin in pregnant women with iron deficiency anemia.Methods A total of 80 pregnant women and healthy pregnant women were selected for regular prenatal examination.The experiments were divided into four groups:healthy control group,normal pregnant women group,pregnant women with mild anemia group,pregnant women with moderate anemia group.All blood samples were collected after 8 h of fasting.Blood routine analysis was performed using a blood cell analyzer LH750.hepcidin,EPO,serum ferritin(SF),and serum transferrin(TRF)were detected by enzyme linked immunosorbent assay.Serum iron and total iron binding capacity(TIBC)were measured by spectrophotometric method.Immunoturbidimetric assay for C-reactive protein(CRP).Results Compared with the healthy control group,hemoglobin(Hb),hematocrit(Hct),SI and hepcidin in the normal group,the mild anemia group and the moderate anemia group were all decreased,while CRP was all increased.Compared with the healthy control group,mean corpuscular volume(MCV),mean corpuscular hemogolobin(MCH)and mean corpuscular hemogolobin concentration(MCHC)were decreased and TIBC was increased in the mild anemia group and the moderate anemia group.Compared with the healthy control group,EPO was increased in the pregnant women with moderate anemia group,with statistically significant differences(P<0.05).Compared with the normal group of pregnant women,Hb,Hct,MCV,MCH,MCHC,SI and TIBC were decreased in the mild anemia group and the moderate anemia group.Compared with the normal group of pregnant women,EPO and CRP in the group of pregnant women with moderate anemia were increased,and the difference was statistically significant(P<0.05).Compared with the mild anemia group,Hb,Hct,MCV,MCH and SI in the moderate anemia group were all decreased,while TIBC and EPO were all increased,with statistically significant differences(P<0.05).Hepcidin was positively correlated with Hb,Hct,MCV,MCH,MCHC and SI,and negatively correlated with TIBC and EPO,with statistically significant differences(P<0.05).Conclusion Iron deficiency anemia in pregnancy may be related to the down-regulation of hepcidin expression,possibly through the inhibition of EPO.