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Son Dönem Böbrek Yetersizlikli Hastalarda Prohepsidin ve Kardiyovasküler Risk Belirteçleri Arasındaki İlişki

Relationship Between Prohepcidin and Cardiovascular Risk Markers in End Stage Renal Failure Patients

Journal Name:

Publication Year:

DOI: 
10.5262/tndt.2013.1003.09
Abstract (2. Language): 
OBJECTIVE: The leading cause of death in patients with end-stage renal disease (ESRD) is cardiovascular disease. Prohepcidin, which is the precursor of hepcidin is a peptide hormone produced by the liver, and appears to be the master regulator of iron homeostasis in humans. High prohepcidin levels may contribute to progression of cardiovascular disease in end-stage renal insuffi ciency patients. However, any such association remains poorly understood. The purpose of the present study was to investigate the relationship between prohepcidin and cardiovascular risk markers in end-stage renal failure patients. MATERIAL and METHODS: Twenty-two chronic hemodialysis patients, 21 chronic peritoneal dialysis patients, and 16 healthy controls were included in the present study. The levels of serum prohepcidin (the precursor form of hepcidin), high sensitivity C-reactive protein (hs-CRP), troponin-T (TT), and cystatin C (CC) were determined using commercial kits. The left ventricular mass index (LVMI) was estimated using echocardiography. RESULTS: The levels of the CVD risk markers TT, CC, and prohepcidin differed, with statistical signifi cance, between the patient and control groups. Prohepcidin level was signifi cantly associated with CC concentration (β=0.855, R2=0.73, p<0.001), TT level (β=0.456, R2=0.20, p=0.002), and the LVMI (β=0.435, R2=0.19, p=0.003). However, no signifi cant association between prohepcidin level and hs-CRP concentration was evident (β=0.124, R2=0.015, p<0.42). CONCLUSION: Our data suggest that the prohepcidin level can serve as a biomarker of cardiovascular disease. This level is closely associated with the cardiovascular risk markers of CC and TT concentrations, as well as the LVMI.
Abstract (Original Language): 
AMAÇ: Hepsidinin öncül molekülü olan prohepsidin karaciğerden yapılan bir peptit hormon olup demir metabolizmasının ana düzenleyicisidir. Son dönem böbrek yetersizlikli hastalarda yüksek prohepsidin seviyelerinin kardiyovasküler hastalıklarla ilişkili olabileceği düşünülmektedir. Ancak bu ilişki net bir şekilde anlaşılamamıştır. Bu çalışmadaki amacımız, SDBY’li hastalarda prohepsidin ile kardiyovasküler risk belirteçleri arasında ilişkiyi araştırmaktır. GEREÇ ve YÖNTEMLER: Çalışmaya 22 kronik hemodiyaliz, 21 kronik periton diyaliz hastası ile birlikte 16 sağlıklı kontrol dahil edildi. Rutin laboratuvar tetkiklerine ilave olarak hastalardan prohepsidin, yüksek hassasiyetli C reaktif protein (hsCRP), troponin T (TT) ve sistatin C (CC) değerleri ölçüldü. Ekokardiyografi ile sol ventrikül kitle indeksleri (LVMI) belirlendi. BULGULAR: Hastaların olduğu gruplarda ölçülen prohepsidin, TT, CC yüksekliği kontrol grubuna göre istatistiksel olarak anlamlıydı. Ayrıca prohepsidin CC (β=0,855, R2=0,73, p<0,001), TT (β=0,456, R2=0,20, p=0,002), LVMI (β=0,435, R2=0,19, p=0,003) ile korelasyon göstermekteydi. HsCRP (β=0,124, R2=0,015, p<0,42) ile ilişki saptanmadı. SONUÇ: Sonuçlarımız prohepsidinin de diğer kardiyovasküler belirteçlerle korelasyon gösterdiği ve bu hastalıkların tespitinde kullanılabileceğini düşündürmektedir.
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