ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Cardiovascular Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1503940
Predictive value of ferritin heavy chains in the development of coronary artery calcification in patients on maintenance hemodialysis: a Prospective Cohort Study
Provisionally accepted
- 1Department of Nephrology and Institute of Nephrology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
- 2University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
- 3Hospital of Stomatology, Sichuan University, Chengdu, Sichuan Province, China
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Background Vascular calcification (VC) is a well-established risk factor for cardiovascular disease (CVD) and mortality in patients on maintenance hemodialysis (MHD). These patients frequently present with hyperphosphatemia as well as disorders of iron metabolism. This study aims to explore the role of ferritin heavy chain (FTH) in the development and progression of coronary artery calcification (CAC) in patients on MHD and assess its predictive value. Methods Using a bioinformatics approach, we analyzed datasets related to VC. In our prospective study, we evaluated the Coronary Artery Calcification Score (CACS) alongside clinical markers, including serum FTH, serum ferritin, and transferrin saturation (TSAT), in patients on MHD at baseline and after a 1-year follow-up. Results Fth1 was identified as a differentially expressed gene significantly upregulated in the aorta of both ApoE-/- mice (atherosclerotic calcification model) and chronic kidney disease (CKD) mice (medial calcification model). Among patients on MHD, 85.71% exhibited CAC, with 49.09% showing progression. Patients with CAC tended to be older and have a higher body mass index (BMI). Notably, serum FTH and phosphorus (P) levels were significantly elevated in those with progressive CAC. Elevated serum FTH and high serum P were both independent risk factors for CAC progression and showed predictive value. Conclusion Elevated serum FTH and high serum phosphorus are clinically significant predictors of VC progression in patients on MHD.
Keywords: Vascular Calcification, Maintenance hemodialysis, Ferritin Heavy Chain, Risk factors, Predictive Value
Received: 14 Oct 2024; Accepted: 10 Jul 2025.
Copyright: © 2025 Chen, Pu, Xia, Zou and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yang Zou, Department of Nephrology and Institute of Nephrology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
Yi Li, Department of Nephrology and Institute of Nephrology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
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