Imanishi Yasuo, Inaba Masaaki, Nakatsuka Kiyoshi, Nagasue Kyoko, Okuno Senji, Yoshihara Asami, Miura Masakazu, Miyauchi Akimitsu, Kobayashi Keisuke, Miki Takami, Shoji Tetsuo, Ishimura Eiji, Nishizawa Yoshiki
Department of Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.
Kidney Int. 2004 May;65(5):1943-6. doi: 10.1111/j.1523-1755.2004.00604.x.
Fibroblast growth factor (FGF)-23 is a recently identified circulating factor which causes renal phosphate wasting disorders. Although the mechanism of regulation of FGF-23 secretion is unknown, plasma FGF-23 level may be regulated or affected by serum phosphate levels because of its hypophosphatemic effect.
We tested the hypothesis that plasma FGF-23 levels may be increased in hyperphosphatemia in patients with end-stage renal disease (ESRD) on maintenance hemodialysis. We measured plasma FGF-23 levels in 158 male uremic patients on maintenance hemodialysis. Plasma samples were obtained before starting dialysis sessions to determine FGF-23 levels by enzyme-linked immunosorbent assay (ELISA).
Plasma FGF-23 level exhibited significant and positive correlations with inorganic phosphate, intact parathyroid hormone (PTH), corrected calcium, and duration of hemodialysis on simple regression analyses. All these associations remained significant in multiple regression analyses.
Serum phosphate, calcium, and intact PTH could be regulators of FGF-23 levels in uremic patients on maintenance hemodialysis. Our results may provide new insights into the pathophysiologic effects of FGF-23 on calcium-phosphate homeostasis.
成纤维细胞生长因子（FGF）-23是最近发现的一种循环因子，可导致肾脏磷酸盐流失紊乱。尽管FGF-23分泌的调节机制尚不清楚，但由于其降磷作用，血浆FGF-23水平可能受血清磷酸盐水平的调节或影响。
我们检验了这样一个假设，即维持性血液透析的终末期肾病（ESRD）患者高磷血症时血浆FGF-23水平可能升高。我们测量了158例接受维持性血液透析的男性尿毒症患者的血浆FGF-23水平。在开始透析治疗前采集血浆样本，通过酶联免疫吸附测定（ELISA）法测定FGF-23水平。
简单回归分析显示，血浆FGF-23水平与无机磷、完整甲状旁腺激素（PTH）、校正钙及血液透析时间呈显著正相关。在多元回归分析中，所有这些关联仍然显著。
血清磷酸盐、钙及完整PTH可能是维持性血液透析尿毒症患者FGF-23水平的调节因子。我们的结果可能为FGF-23对钙磷稳态的病理生理作用提供新的见解。
