肾小球滤过率下降是慢性肾脏病患者 FGF-23 升高的最重要决定因素。
Impaired GFR is the most important determinant for FGF-23 increase in chronic kidney disease.
机构信息
Department of Pediatrics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada N6A 5W9.
出版信息
Clin Biochem. 2011 Apr;44(5-6):435-7. doi: 10.1016/j.clinbiochem.2011.01.009. Epub 2011 Feb 1.
OBJECTIVES
It is unclear whether fibroblast growth factor-23 (FGF-23) increases in response to phosphate accumulation or to decrease clearance in chronic kidney disease (CKD) as is the case with other low molecular weight proteins such as cystatin C (CysC).
DESIGN AND METHODS
This cross-sectional study measured serum FGF-23, CysC, and other serum markers of bone metabolism in 69 patients, aged 18 months-24 years, with various stages of CKD (eGFR=11-214mL/min).
RESULTS
FGF-23 levels were significantly correlated with CysC and parathyroid hormone levels (PTH) on univariate non-linear regression analysis. In multivariate linear regression analysis, log (CysC) (β=0.660, p<0.0001), log (PTH) (β=0.038, p=0.37), and phosphate (β=0.222, p=0.028) explained 69.1% of the variance of FGF-23.
CONCLUSIONS
CysC had the largest unique contribution to FGF-23 variance in this model, supporting the hypothesis that renal clearance may be the most responsible factor for elevated FGF-23 levels in early stages of CKD.
目的
目前尚不清楚成纤维细胞生长因子 23（FGF-23）是响应于磷酸盐蓄积而增加，还是像胱抑素 C（CysC）等其他低分子量蛋白质那样由于清除率降低而增加，在慢性肾脏病（CKD）中就是如此。
设计和方法
本横断面研究测量了 69 例年龄在 18 个月至 24 岁之间的患有各种 CKD 阶段（eGFR=11-214mL/min）患者的血清 FGF-23、CysC 和其他骨代谢血清标志物。
结果
在单变量非线性回归分析中，FGF-23 水平与 CysC 和甲状旁腺激素（PTH）水平呈显著相关。在多元线性回归分析中，log（CysC）（β=0.660，p<0.0001）、log（PTH）（β=0.038，p=0.37）和磷酸盐（β=0.222，p=0.028）解释了 FGF-23 变异的 69.1%。
结论
在该模型中，CysC 对 FGF-23 变异的贡献最大，支持了这样一种假设，即肾脏清除可能是 CKD 早期 FGF-23 水平升高的最主要因素。
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