Xiao Dong-Mei, Wu Qing, Fan Wei-Feng, Ye Xian-Wu, Niu Jian-Ying, Gu Yong
Division of Nephrology, the Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China; Division of Internal Medicine, Ningbo First Hospital, Medical School of Ningbo University, Ningbo, China.
Hemodial Int. 2013 Oct;17(4):483-92. doi: 10.1111/hdi.12033. Epub 2013 Mar 12.
This study was aimed to explore the role of serum fibroblast growth factor (FGF)-23, matrix Gla protein (MGP) and fetuin-A in the calcium-phosphate metabolism and their predicting value in coronary artery calcification in maintenance hemodialysis (MHD) patients. This study included 64 patients who receive hemodialysis in our hospital. The serum FGF-23, MGP and fetuin-A were analyzed by enzyme-linked immunosorbent assay (ELlSA). Coronary artery calcification score (CACS) was evaluated by coronary artery computed tomography scan. The 64 patients (30 males, 34 females, 60.6 ± 11.3 years of age) received an average dialysis vintage of 6.88 ± 2.94 years. We divided the CACS into three levels, and 13 (20.31%), 16 (25%), and 35 (54.69%) exhibited a CACS of 0-100, 100-400, and >400, respectively. Dialysis vintage, serum FGF-23, fetuin-A, phosphorus and high-density lipoprotein-C levels were identified as independent variables of CACS by stepwise multiple regression analysis. The area under receiver operating characteristic curve indicated that serum FGF-23 and fetuin-A were useful for identifying CAC in MHD patients. The cut-off value corresponding to the highest Youden's index was serum FGF-23 ≥ 256 pg/mL and fetuin-A ≤ 85 μg/mL, which was defined as the optimal predictors of CAC. Different combinations of serum FGF-23 and fetuin-A in parallel or in series effectively boosted the identification of CAC. The incidence of CAC is high in MHD patients. Serum FGF-23 and fetuin-A levels are closely correlated with CAC.
本研究旨在探讨血清成纤维细胞生长因子（FGF）-23、基质Gla蛋白（MGP）和胎球蛋白-A在维持性血液透析（MHD）患者钙磷代谢中的作用及其对冠状动脉钙化的预测价值。本研究纳入了64例在我院接受血液透析的患者。采用酶联免疫吸附测定（ELISA）法分析血清FGF-23、MGP和胎球蛋白-A。通过冠状动脉计算机断层扫描评估冠状动脉钙化评分（CACS）。64例患者（男性30例，女性34例，年龄60.6±11.3岁）平均透析龄为6.88±2.94年。我们将CACS分为三个水平，分别有13例（20.31%）、16例（25%）和35例（54.69%）的CACS为0 - 100、100 - 400和>400。通过逐步多元回归分析确定透析龄、血清FGF-23、胎球蛋白-A、磷和高密度脂蛋白-C水平为CACS的独立变量。受试者工作特征曲线下面积表明，血清FGF-23和胎球蛋白-A有助于识别MHD患者的冠状动脉钙化。对应最高约登指数的截断值为血清FGF-23≥256 pg/mL和胎球蛋白-A≤85 μg/mL，将其定义为冠状动脉钙化的最佳预测指标。血清FGF-23和胎球蛋白-A的不同平行或串联组合有效提高了冠状动脉钙化的识别率。MHD患者冠状动脉钙化的发生率较高。血清FGF-23和胎球蛋白-A水平与冠状动脉钙化密切相关。
