Inci A, Sari F, Olmaz R, Coban M, Dolu S, Sarikaya M, Ellidag H Y
Division of Nephrology, Internal Medicine, Antalya Training and Research Hospital, Antalya, Turkey.
Eur Rev Med Pharmacol Sci. 2016 Jul;20(15):3230-7.
In this cross-sectional study, we investigate the relationship between soluble Klotho (s-Klotho) levels, markers of bone mineral metabolism and arterial stiffness in 109 diabetic nephropathy patients (median age 61.00± 9.77 years) and 32 healthy controls (median age 49.23 ± 7.32 years).
Blood samples were collected to measure the levels of s-Klotho, and FGF23, serum creatinine, Calcium (Ca), Phosphorus (P), 25-hydroxyvitamin D3 (25hD) and parathyroid hormone (PTH). Pulse wave velocity (PWV) and blood pressure were also measured using a combined monitor.
s-Klotho, FGF23 and PTH levels were significantly higher and 25hD was significantly lower in the patients than in controls (p < 0.001). Systolic blood pressure, pulse pressure and PWV were also significantly higher in the patients (p < 0.001). s-Klotho, FGF23 and 25hD levels significantly varied between sub-groups according to CKD stages, defined according to the CKD epidemiology collaboration equation. A strong positive correlation was found between s-Klotho and FGF23 (r = 0.768, p = 0.001) levels, but not with other bone mineral metabolism, blood pressure or arterial stiffness parameters. Creatinine levels significantly differed (p = 0.009) between three s-Klotho-level sub-groups, with the high creatinine levels in the sub-group with the lowest s-Klotho levels and estimated glomerular filtration rate (eGFR).
There was no correlation between eGFR and s-Klotho levels. Arterial stiffness increased in CKD but was not related to s-Klotho or FGF23 levels. Among all parameters, FGF23 levels had the greatest effect on s-Klotho levels.
在这项横断面研究中，我们调查了109例糖尿病肾病患者（中位年龄61.00±9.77岁）和32例健康对照者（中位年龄49.23±7.32岁）的可溶性klotho（s-Klotho）水平、骨矿物质代谢标志物与动脉僵硬度之间的关系。
采集血样以测定s-Klotho、成纤维细胞生长因子23（FGF23）、血清肌酐、钙（Ca）、磷（P）、25-羟维生素D3（25hD）和甲状旁腺激素（PTH）的水平。还使用组合监测仪测量脉搏波速度（PWV）和血压。
患者的s-Klotho、FGF23和PTH水平显著高于对照组，而25hD水平显著低于对照组（p<0.001）。患者的收缩压、脉压和PWV也显著更高（p<0.001）。根据慢性肾脏病流行病学合作方程定义的慢性肾脏病阶段，各亚组之间的s-Klotho、FGF23和25hD水平存在显著差异。s-Klotho与FGF23水平之间存在强正相关（r=0.768，p=0.001），但与其他骨矿物质代谢、血压或动脉僵硬度参数无关。三个s-Klotho水平亚组之间的肌酐水平存在显著差异（p=0.009），s-Klotho水平和估计肾小球滤过率（eGFR）最低的亚组中肌酐水平最高。
eGFR与s-Klotho水平之间无相关性。慢性肾脏病患者的动脉僵硬度增加，但与s-Klotho或FGF23水平无关。在所有参数中，FGF23水平对s-Klotho水平的影响最大。
