Iron status and cardiovascular risk factors in patients with haemodialysis versus patients with ischaemic heart disease

SUMMARY Aim: The study aimed to investigate whether imbalanced iron status in patients with haemodialysis coexisted with abnormal lipid profile, higher inflammatory status and altered growth hormone–insulin‐like growth factor (GH–IGF)‐I axis and to compare these biochemical markers with patients with ischaemic heart disease. Methods: Serum samples for biochemical and immunological analyses were collected from 74 normal subjects, 138 patients with ischaemic heart disease (IHD) and 115 patients on haemodialysis (HD). Results: Compared with normal subjects, lower serum iron, lower total iron‐binding capacity (TIBC) and higher ferritin in HD patients coexisted with decreases in high‐density lipoprotein cholesterol and total bilirubin as well as increases in lactate dehydrogenase (LDH), interleukin (IL)‐6, C‐reactive protein (CRP) and IL‐10. Decreased IGF‐I and increased GH were found in HD patients whereas unchanged GH–IGF axis were found in IHD patients. Compared with IHD, much higher ferritin, lower TIBC, lower bilirubin and higher LDH levels were found in HD patients. Conclusion: Imbalanced iron status in patients on HD coexisted with abnormal lipid profiles, increased anaerobic activity and higher inflammatory status, which suggests that imbalanced iron status in HD patients may play a deleterious role in cardiovascular pathophysiology. Altered GH–IGF axis found in HD patients was more obvious than in IHD patients. This may imply that the GH–IGF axis system is modulated or adapted by HD.