Relationship Between Serum Hepcidin Levels And Cardiovascular Disease In Patients With Maintenance Hemodialysis

Background: To investigate the serum level of hepcidin and its relationship with cardiovascular disease (CVD) in maintenance hemodialysis (MHD) patients. Methods: Blood was obtained from 75 MHD patients before undergoing hemodialysis and 20 healthy controls. Serum hepcidin, advanced oxidation protein products (AOPP) and interleukin (IL)-6 were measured by enzyme-linked immunosorbant assay (ELISA). Spearman correlation, and binary logistic regression linear regression analyses were used to assess the relationship between serum hepcidin and other parameters. Results: The serum level of hepcidin, AOPP and IL-6 was significantly up-regulated in MHD patients compared with the control (P < 0.05). Furthermore, serum hepcidin levels in patients with CVD were higher than those in patients without CVD (P < 0.05). In all MHD patients, serum hepcidin level was correlated positively with erythropoietin (EPO) dose per week (rho = 0.251, P = 0.030), EPO resistance index (rho = 0.268, P = 0.020), ferritin (rho = 0.814, P < 0.001), transferin saturation (TSAT, rho = 0.263, P = 0.023), AOPP (rho = 0.280, P = 0.049), high sensitive C reactive protein (rho = 0.151, P = 0.006), IL-6 (rho = 0.340, P = 0.003) and left ventricular mass index (LVMI, rho = 0.290, P - 0.033). Moreover, it was negatively correlated with serum pre-albumin (p = 0.266, P = 0.021), total iron-binding capacity (TIBC, rho = 0.458, P < 0.001), unsaturated iron-binding capacity (UIBC, rho = -0.473, P < 0.001) and transferrin (rho = -0.487, P < 0.001). Linear regression analysis showed that ferritin (beta = 0.708, P < 0.001), TIBC = (beta = 0.246, P = 0.032) and IL-6 (beta = 0.209, P = 0.041) were independently associated with hepcidin. Results of binary logistic regression analysis suggested that higher serum hepcidin level (>249.2 ng/mL) was positively and independently related to CVD (OR = 1.32, 95% CI [1.20-9.56], P = 0.043). Conclusions: Serum hepcidin level is associated with CVD in MHD patients, indicating that hepcidin may be a novel biomarker and therapeutic target for CVD.