INSERM ERI-12 (EA 4292), UFR de Médecine et Pharmacie, Jules Verne University of Picardy, Amiens, France.
Osteoporos Int. 2012 Jul;23(7):2017-25. doi: 10.1007/s00198-011-1838-0. Epub 2011 Nov 23.
The hormone fibroblast growth factor 23 (FGF23) is involved in mineral homeostasis but may also have a role in vascular calcification and bone mineralization. In a cohort of 142 patients with CKD stages 2-5D, plasma FGF23 was independently associated with aortic calcification but not with pulse wave velocity or bone mineral density.
FGF23 is involved in mineral homeostasis but may also have a role in vascular calcification and bone mineralization. Previous studies related to FGF23 and vascular and bone outcomes have been restricted to dialysis patients. The aim of the present study was to establish whether or not plasma FGF23 is associated with aortic and coronary calcification, arterial stiffness, and bone mineral density in patients with early as well as late stages of CKD.
In a cohort of 142 patients with CKD stages 2-5D, we made routine biochemistry and intact FGF23 determinations, and assessed aortic and coronary calcification, bone mineral density (BMD), and arterial stiffness by multislice spiral computed tomography and automated pulse wave velocity (PWV).
Plasma intact FGF23 levels were elevated in CKD patients; the elevation preceded that of serum phosphate in early-stage CKD. Patients with elevated FGF23 levels had higher aortic and coronary calcification scores than patients with lower FGF23 levels. Multivariate linear regression analysis indicated that only age (p < 0.001) and FGF23 (p = 0.008) were independently associated with aortic calcification score. Plasma FGF23 was neither associated with PWV nor with BMD.
Our data suggest that plasma FGF23 is an independent biomarker of vascular calcification in patients with various CKD stages including early stages. The association between vascular calcification and FGF23 levels appears to be independent of BMD. It remains to be seen whether this association is independent of bone turnover and bone mass.
激素成纤维细胞生长因子 23（FGF23）参与矿物质稳态，但也可能在血管钙化和骨矿化中发挥作用。在一个包含 142 名 CKD 2-5D 期患者的队列中，血浆 FGF23 与主动脉钙化独立相关，但与脉搏波速度或骨密度无关。
FGF23 参与矿物质稳态，但也可能在血管钙化和骨矿化中发挥作用。以前与 FGF23 及血管和骨骼结果相关的研究仅限于透析患者。本研究旨在确定血浆 FGF23 是否与 CKD 早期和晚期患者的主动脉和冠状动脉钙化、动脉僵硬度和骨密度相关。
在一个包含 142 名 CKD 2-5D 期患者的队列中，我们进行了常规生化和完整 FGF23 测定，并通过多层螺旋 CT 和自动脉搏波速度（PWV）评估了主动脉和冠状动脉钙化、骨密度（BMD）和动脉僵硬度。
CKD 患者的血浆完整 FGF23 水平升高；在 CKD 早期，其升高先于血清磷酸盐升高。FGF23 水平升高的患者的主动脉和冠状动脉钙化评分高于 FGF23 水平较低的患者。多元线性回归分析表明，只有年龄（p<0.001）和 FGF23（p=0.008）与主动脉钙化评分独立相关。血浆 FGF23 与 PWV 或 BMD 均无关。
我们的数据表明，血浆 FGF23 是各种 CKD 阶段包括早期阶段患者血管钙化的独立生物标志物。血管钙化与 FGF23 水平之间的关联似乎独立于 BMD。这种关联是否独立于骨转换和骨量仍有待观察。
