Hepcidin and diabetes are independently related with soluble transferrin receptor levels in chronic dialysis patients

Belo, Luı́s; Rocha, Susana; Valente, Maria João; Coimbra, Susana; Catarino, Cristina; Bronze-da-Rocha, Elsa; Rocha‐Pereira, Petronila; Faria, Maria do Sameiro; Oliveira, José Arimátes de; Madureira, José; Fernandes, João; Miranda, Vasco; Santos-Silva, Alice

doi:10.1080/0886022x.2019.1635893

Cited by 12 publications

(13 citation statements)

References 47 publications

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“…sTfR is a dimeric protein present in serum, which is a part of the transferrin receptor after enzymatic cleavage [58]. In the study of Belo et al [59], sTfR values were higher in hemodialyzed diabetic patients when compared to hemodialyzed non-diabetic patients and were significantly correlated with circulating iron, ferritin, transferrin saturation, hepcidin, MCH, and MCHC. There were no statistically significant differences in GDF-15 and hepcidin between diabetic and non-diabetic patients who were on hemodialysis in their study.…”

Section: Discussionmentioning

confidence: 98%

Novel Iron Parameters in Patients with Type 2 Diabetes Mellitus in Relation to Kidney Function

Zapora-Kurel

Kuźma

Zakrzewska

et al. 2021

JCM

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Background/aims: Anemia of chronic disease is a common feature in diabetes and chronic kidney disease. Hepcidin is the key element involved in iron metabolism; however, studies on new indices of iron status are still ongoing. The aim of the study was to assess novel iron parameters in patients with type 2 diabetes mellitus in relation to kidney function. Methods: The study included 80 type 2 diabetic patients and 23 healthy volunteers. Standard laboratory measurements were used to measure the iron status, complete blood count, creatinine, the estimated glomerular filtration rate (eGFR), serum lipids, and brain natriuretic peptides (BNPs). Commercially available kits were used to measure hepcidin-25, the soluble transferrin receptor (sTfR), growth differentiation factor-15 (GDF-15), and hypoxia-inducible factor-1 alpha. Results: Anemia was present in 65% of the studied patients. The control group was found to have significantly higher hepcidin, sTfR, and GDF-15, and lower hemoglobin and iron. When compared with patients with eGFR values ≥60 mL/min/1.73 m2 and <60 mL/min/1.73 m2, we found that patients with higher eGFR had higher hemoglobin, ferritin, and HIF-1 alpha, lower BNP, and were younger. We found that levels of HIF-1 alpha are negligible in the studied population and were related to age only in patients with eGFR values ≥60 mL/min/1.73 m2. Conclusion: A comprehensive assessment of iron status is rarely performed. Novel biomarkers of iron metabolism are not generally related to kidney function. Whether the assessment of HIF-1 alpha would be a marker of efficient anemia therapy with HIF-prolyl hydroxylase inhibitors is still a matter for further study.

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Section: Discussionmentioning

confidence: 98%

Novel Iron Parameters in Patients with Type 2 Diabetes Mellitus in Relation to Kidney Function

Zapora-Kurel

Kuźma

Zakrzewska

et al. 2021

JCM

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“…рТФР -продукт протеолиза рецептора в определенном сайте внеклеточного домена. Отщепленные мономеры рТФР могут быть определены в плазме или сыворотке [36,37].…”

Section: Discussionunclassified

“…Исследования, направленные на оценку рТФР при СД [36,37], представлены в мировой литературе ограниченно, а работ, целью которых являлось бы установление чувствительности и специфичности указанного маркера в отношении ЖДА именно для когорты пациентов с СД, не представлено вообще.…”

Section: Discussionunclassified

The question of differential diagnosis of anemia in diabetes mellitus

Saprina,

Musina,

Prokhorenko

et al. 2023

Diabetes mellitus

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BACKGROUND: High prevalence of anemia in diabetes mellitus (DM) determines the relevance of studying its pathogenetic aspects, the role of anemia in DM complications development and the issue of differential diagnosis between iron deficiency anemia (IDA) and anemia of chronic disease (ACD)).AIM: To establish the diagnostic value of classical parameters for diagnosing anemia in DM and propose an optimized algorithm for the differential diagnosis of ACD and IDA in DM type 1 and 2 using new markers.MATERIALS AND METHODS: The observational, single-centre, comparative, controlled, single-stage study. Patients underwent assessment of glycated hemoglobin, creatinine, microalbuminuria; indicators of iron metabolism — hematocrit, the number of erythrocytes, reticulocytes, hemoglobin, serum iron, transferrin, ferritin, the level of soluble transferrin receptors (sTfR), sTfR/logFerpitin index, and inflammation markers — erythrocyte sedimentation rate (ESR), leukocyte count, high sensitive CRP and TNF-α. ROC-analysis was used to assess the differential diagnosis markers informative content.RESULTS: We examined 135 patients: 51 with DM 1 and 84 with DM 2. The patients were stratified into groups based on anemia type: 1) ACD 2) IDA 3) latent iron deficiency 4) without ferrokinetics disorders. According to the ROC-analysis in DM patients, the following parameters had high information content in ACD. ESR — sensitivity 92%, specificity 85%, diagnostic threshold 26.5 mm/h (area under the curve (AUC) 0.943; p<0.0001); leukocyte count — sensitivity 69%, specificity 64%, diagnostic threshold 7.50x109/l (AUC 0.727; p=0.007), microalbuminuria — sensitivity 71%, specificity 72%, diagnostic threshold 29.5 mg/l (AUC 0.744; p=0.003). In DM sTfR and the sTfR /logFerritin index had high information content in IDA at diagnostic thresholds different from those for general population. The sensitivity of sTfR 71%, the specificity 71%, diagnostic threshold 1.42 ng/mL (2.9 ng/mL for general population) (AUC 0.765; p=0.024). The sensitivity of sTfR/logFerritin index 100%, the specificity 97%, diagnostic threshold 1.48 (2.0 for general population) (AUC 0.983; p=0.024).CONCLUSION: In differential diagnosis of IDA and ACD in DM, ESR, leukocyte count, microalbuminuria, sTfR and sTfR/logFerritin index have a high diagnostic value. This allows proposing them as additional markers for differential diagnosis of anemia in DM.

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“…Hepcidin is also important for innate immunity (22). In chronic inflammatory status, enhanced serum hepcidin synthesis has been correlated with increased interleukin-6 and CRP (23). Previous studies showed that dialysis patients had higher levels of serum hepcidin compared to general population, possibly due to impaired renal excretion, chronic inflammatory status, iron administration, ESA dose, and inadequate dialysis (24,25).…”

Section: Discussionmentioning

confidence: 99%

Serum Hepcidin-25 and Risk of Mortality in Patients on Peritoneal Dialysis

Zhong

Luo

et al. 2021

Front. Med.

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Background: Increased serum hepcidin-25 level is associated with excess mortality in hemodialysis patients. However, there is a dearth of published information about its predictive effect for survival in patients on peritoneal dialysis (PD). The purpose of this study is to evaluate the association of serum hepcidin-25 with the risk of mortality in PD patients.Methods: Serum hepcidin-25 level was measured using an enzyme-linked immunosorbent assay in a prospective cohort study of PD patients with stored serum samples at baseline. Multivariate linear regression model was used to determine clinical characteristics associated with serum hepcidin-25 concentration. We evaluated the relationship between serum hepcidin-25 and all-cause mortality using a Cox proportional hazards model and the relationship between hepcidin-25 and cardiovascular (CV) and infection-related deaths using competing-risks regression models.Results: In total, 513 PD patients were included in this study. The median serum hepcidin-25 level was 40.9 (17.9–85.9) ng/mL. Body mass index and serum ferritin were positively correlated with serum hepcidin-25 levels. During a median follow-up period of 64.1 months, 122 (24%) patients died, including 61 (50%) CV deaths and 32 (26%) infection-related deaths. In multivariable analysis, patients with the highest tertile of serum hepcidin-25 had a greater risk of all-cause [adjusted hazard ratio (aHR) 1.85, 95% confidence interval (95%CI), 1.14 to 3.00, P = 0.013] and infection-related mortality (adjusted subdistribution hazard ratio [aSHR], 2.61; 95%CI, 1.01 to 6.76, P = 0.049) when compared with those in the second tertile. However, no significant relationship was observed between serum hepcidin-25 and CV mortality.Conclusions: Higher baseline serum hepcidin-25 level was associated with increased risk for all-cause and infection-related mortality in PD patients.

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Hepcidin and diabetes are independently related with soluble transferrin receptor levels in chronic dialysis patients

Cited by 12 publications

References 47 publications

Novel Iron Parameters in Patients with Type 2 Diabetes Mellitus in Relation to Kidney Function

Novel Iron Parameters in Patients with Type 2 Diabetes Mellitus in Relation to Kidney Function

The question of differential diagnosis of anemia in diabetes mellitus

Serum Hepcidin-25 and Risk of Mortality in Patients on Peritoneal Dialysis

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