Relationship between serum ferritin,uncoupling protein 2 and angiopoietin-like protein 4 and left ventricular hypertrophy in maintenance hemodialysis patients

ZHANG Xiao-min; GUO Ya-juan; CHEN Xiao-zhen

doi:10.3969/j.issn.1672-5301.2025.12.012

Abstract：Objective To investigate the relationship between the serum ferritin(SF),uncoupling protein 2(UCP2)and angiopoietin-like protein 4(ANGPTL4)and left ventricular hypertrophy(LVH)in maintenance hemodialysis(MHD)patients.Methods From February 2023 to February 2025,148 MHD patients treated in Handan First hospital were served as the study group.The presence of LVH was determined based on the left ventricular mass index(LVMI);and the patients were classified into the concurrent group(n=52)and the non concurrent group(n=96).Another 120 healthy individuals with normal kidney function who underwent physical check up in our hospital were considered as the control group.ELISA method was used to detect the serum SF,UCP2 and ANGPTL4.The relationship between LVMI and the serum SF,UCP2 and ANGPTL4 was explored.Multivariate Logistic regression was used to look for influencing factors of LVH in MHD patients.ROC curve was used to explore the predictive value of serum SF,UCP2 and ANGPTL4 for LVH in MHD patients.Results The expression levels of serum SF and ANGPTL4 in the study group were significantly higher than those in the control group[(376.05±82.46)μg/L vs.(216.75±48.27)μg/L,(36.49±6.15)ng/ml vs.(21.83±4.26)ng/ml].The serum UCP2 level was significantly lower than that of the control group[(3.15±0.32)μg/L vs.(4.26±0.53)μg/L,P<0.05].The levels of LVMI,C-reactive protein(CRP),serum SF and ANGPTL4 in the concurrent group were significantly higher than those in the non-concurrent group[(161.28±32.25)g/m2 vs.(103.92±16.38)g/m2,(8.59±1.23)mg/L vs.(6.98±1.35)mg/L,(426.31±69.18)μg/L vs.(348.82±55.35)μg/L,(42.59±9.26)ng/ml vs.(33.18±7.65)ng/ml].The levels of hemoglobin and serum UCP2 were significantly lower than those in the non-concurrent group[(82.96±12.46)g/L vs.(97.45±20.18)g/L,(2.79±0.38)μg/L vs.(3.34±0.49)μg/L,P<0.05].The serum SF and ANGPTL4 in MHD patients were positively correlated with LVMI,while the serum UCP2 was negatively correlated with LVMI(r=0.508,0.536,-0.469,P<0.05).Serum SF,UCP2,ANGPTL4,hemoglobin and CRP were the influencing factors of LVH in MHD patients(P<0.05).The AUC of serum SF,UCP2 and ANGPTL4 in predicting LVH in MHD patients were 0.846,0.763,and 0.859,respectively.The AUC of the combined prediction of the three indicators increased to 0.940,and the prediction efficiency of the combined model was significantly better than that of each single indicator(Zjoint-SF=2.667,P=0.008,Zjoint-UCP2=4.104,P=0.000,Zjoint-ANGPTL4=2.373,P=0.018),with 92.31%and 86.46%,of the sensitivity and specificity respectively.Conclusion The occurrence of LVH in MHD patients is closely related to the significantly increased levels of serum SF and ANGPTL4 and the significantly decreased level of UCP2.The combined detection of the three indicators can more effectively predict the risk of LVH than any single indicator,which is beneficial for the early diagnosis of LVH.