The relationship between serum levels of nuclear factor erythroid 2-related factor 2,hepcidin 25 and insulin-like growth factor 1 and anemia in cancer patients undergoing chemotherapy
Feng Hengrong
Ding Changping
Xu Lei
Liu Fudi
Abstract：Objective To investigate the relationship between the levels of serum nuclear factor erythroid 2-related factor 2(Nrf2),hepcidin 25(Hepc-25)and insulin-like growth factor 1(IGF-1)and anemia in cancer patients undergoing chemotherapy.Methods A total of 142 tumor patients admitted to the Affiliated Hospital of Yangzhou University from January 2022 to January 2024 were selected.According to whether anemia occurred after chemotherapy,they were divided into observation group(anemia occurred,89 cases)and control group(no anemia occurred,53 cases).According to the severity of anemia,the patients in the observation group were divided into mild group(23 cases),moderate group(44 cases)and severe group(22 cases).The levels of Nrf2,Hepc-25 and IGF-1 were detected by enzyme-linked immunosorbent assay.Multivariate Logistic regression was used to analyze the influencing factors of anemia in patients during tumor chemotherapy.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of Nrf2,Hepc-25 and IGF-1 in anemia.Results The hemoglobin and red blood cell count of the observation group were significantly lower than those of the control group,and the proportions of female and gastric cancer patients were significantly higher than those of the control group(all P＜0.05).The serum levels of Nrf2 and IGF-1 in the observation group were lower than those in the control group[(1.36±0.24)μg/L vs(2.98±0.53)μg/L,(166±20)μg/L vs(192±27)μg/L],and the serum levels of Hepc-25 were higher than those in the control group[(49±6)μg/L vs(23±4)μg/L](all P＜0.05).The serum levels of Nrf2 and IGF-1 in the mild group,the moderate group and the severe group decreased in turn,and the serum levels of Hepc-25 increased in turn(all P＜0.05).The results of multivariate Logistic regression analysis showed that Hepc-25,female,gastric cancer were the risk factors for anemia(all P＜0.05),while Nrf2,IGF-1,hemoglobin and red blood cell count were protective factors for anemia induced by tumor chemotherapy(all P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of Nrf2,Hepc-25 and IGF-1 in predicting anemia was 0.867,0.841 and 0.797,respectively.When combined,the AUC increased to 0.954.Conclusion The serum levels of Nrf2 and IGF-1 are decreased and Hepc-25 is increased in the cancer patients with anemia after chemotherapy.The serum levels of Nrf2 and IGF-1 are related to the occurrence of anemia in the cancer patients with anemia after chemotherapy,and the combined use of the three factors can effectively predict the occurrence of anemia in the cancer patients with anemia after chemotherapy.
Keywords：TumorChemotherapyAnemiaNuclear factor erythroid 2-related factor 2Hepcidin 25Insulin-like growth factor 1
Publication Date：2025-05-18
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 715-719 )