Impact of ferroptosis-related gene expression on cardiovascular outcomes in chronic renal failure
10.3969/j.issn.1673-4130.2025.19.012
- VernacularTitle:铁死亡相关基因表达对慢性肾功能衰竭患者心血管结局的影响
- Author:
Xuelan LIN
1
;
Kexin LIU
;
Xiao GE
;
Yiming YU
;
Lifang CAO
Author Information
1. 潍坊市人民医院全科医学科,山东潍坊 261000
- Keywords:
chronic renal failure;
cardiovascular event;
ferroptosis;
heme oxygenase-1;
solute car-rier family 7 member 11;
long-chain acyl coenzyme A synthase 4
- From:
International Journal of Laboratory Medicine
2025;46(19):2378-2384,2390
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the relationship between ferroptosis-related genes[heme oxygenase-1(HO-1),solute carrier family 7 member 11(SLC7A11),and long-chain acyl-coenzyme A synthetase 4(ACSL4)]expression and cardiovascular events in patients with chronic renal failure(CRF),aiming to pro-vide clinical insights for risk assessment of cardiovascular complications.Methods A total of 124 CRF pa-tients(CRF group)admitted to the hospital from January 2020 to January 2023 and 124 healthy people(con-trol group)who underwent physical examination in the hospital during the same period were selected as the research objects.The levels of ferroptosis-related gene HO-1,SLC7A11 and ACSL4 were detected and com-pared between the two groups.CRF patients were followed up for 12 months after discharge,and they were di-vided into concurrent group(n=56)and non-concurrent group(n=66)according to the occurrence of cardio-vascular events.Spearman correlation analysis was used to investigate the correlation between iron death relat-ed genes HO-1,SLC7A11,ACSL4 and cardiovascular events in CRF patients.Univariate and multivariate Lo-gistic regression analysis were used to investigate the influencing factors of cardiovascular events in CRF pa-tients.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of iron death re-lated genes HO-1,SLC7A11,and ACSL4 for cardiovascular events in CRF patients.Results Serum HO-1 and SLC7A11 levels in CRF group were lower than those in control group(P<0.05),and the ACSL4 level was higher than that in control group(P<0.05).The serum HO-1 and SLC7A11 levels in concurrent group were lower than those in non-concurrent group(all P<0.05),and the serum ACSL4 level was higher than that in non-concurrent group(P<0.05).Ferroptosis-related genes HO-1 and SLC7A11 were negatively correlated with cardiovascular events(r=-0.708,—0.721,P<0.05),while ACSL4 was positively correlated with car-diovascular events(r=0.699,P<0.05).High serum ACSL4 expression and high cTnT level were risk fac-tors for cardiovascular events in CRF patients(P<0.05),and high hemoglobin level and high serum HO-1 and SLC7A11 expression were protective factors for cardiovascular events in CRF patients(P<0.05).ROC curve analysis results showed that the area under the curve(AUC)of serum HO-1,SLC7A11,ACSL4,hemo-globin and cTnT alone for predicting cardiovascular events in CRF patients were 0.787,0.735,0.773,0.651 and 0.782,respectively.The AUC of the combined prediction of ferroptosis-related genes was 0.837,and the AUC of the combined application of five factors was 0.880.According to Delong's test,the AUC of both com-bined application models was significantly higher than those of individual application(P<0.05).The nomo-gram model showed that all ferroptosis-related genes were positively expressed(HO-1<1.5,SLC7A11<1.15,ACSL4≥2.75),and the risk of developing concurrent cardiovascular events in CRF patients could reach over 75%.Conclusion The expression of serum HO-1 and SLC7A11 in CRF patients is decreased,and the ACSL4 expression is increased,which is closely related to cardiovascular events,and the combined detection of three indexes has high value in predicting cardiovascular events in CRF patients.