Erythrocyte Membrane Fatty Acid Remodeling and Zinc Protoporphyrin Alterations Associated with Anemia Severity in Hemodialysis Patients


Kılıç M., Dheir H., İslam M., Ercan Z., SERDAR M. A.

Biomedicines, cilt.14, sa.7, 2026 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 14 Sayı: 7
  • Basım Tarihi: 2026
  • Doi Numarası: 10.3390/biomedicines14071582
  • Dergi Adı: Biomedicines
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, Directory of Open Access Journals, Natural Science Collection (ProQuest), Biological Science Database (ProQuest)
  • Anahtar Kelimeler: erythrocyte membrane fatty acids, hemodialysis patients, hemoglobin, iron-restricted erythropoiesis, ZnPP
  • Acıbadem Mehmet Ali Aydınlar Üniversitesi Adresli: Evet

Özet

Background: This study investigated the relationship between erythrocyte membrane fatty acids, omega-3 index, and zinc protoporphyrin (ZnPP) levels in hemodialysis (HD) patients across hemoglobin-defined anemia severities. Methods: This prospective cross-sectional study included 117 chronic HD patients and 28 healthy controls. ZnPP was measured by high-performance liquid chromatography, and erythrocyte membrane fatty acids by gas chromatography–mass spectrometry. Results: HD patients showed a significantly lower omega-3 index than controls (p < 0.0001), although it did not differ across hemoglobin-defined groups (p = 0.589). Palmitic and erucic acid were higher, whereas oleic acid was lower, in patients with lower hemoglobin. In unadjusted analyses, hemoglobin correlated inversely with palmitic acid (r = −0.220, p = 0.017) and erucic acid (r = −0.183, p = 0.048), whereas the positive association with oleic acid (r = 0.451, p < 0.0001) remained significant after false discovery rate (FDR) correction. ZnPP increased as hemoglobin decreased (p = 0.013) and was negatively associated with hemoglobin (r = −0.406, p < 0.0001). Conclusions: HD patients with lower hemoglobin showed altered erythrocyte membrane fatty acid composition; among fatty acids, only the oleic acid–hemoglobin association remained significant after FDR correction. ZnPP rose as hemoglobin declined and was independently inversely associated with hemoglobin after multivariable adjustment (β = −0.051, p < 0.0001), independent of any dichotomous reference definition, supporting ZnPP as a continuous marker of anemia severity and iron-restricted erythropoiesis in HD patients.