Resende Aline L, Elias Rosilene M, Wolf Myles, Dos Reis Luciene M, Graciolli Fabiana G, Santos Geuza D, Dias Cristiane B, Jorgetti Vanda, Woronik Viktoria, Moysés Rosa M A
Department of Medicine, Division of Nephrology, Universidade de São Paulo, Brazil.
Division of Nephrology and Hypertension, Department of Medicine, Center for Translational Metabolism and Health, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
Cytokine. 2017 Mar;91:124-127. doi: 10.1016/j.cyto.2016.12.022. Epub 2017 Jan 4.
Fibroblast growth factor 23 (FGF23), a phosphate-regulating hormone is an established cardiovascular risk factor. Recently, FGF23 has been related to inflammation. Lupus is an inflammatory disease, and whether FGF23 is associated with Lupus nephritis (LN) activity is unknown.
We studied 15 pre-menopausal patients with recent LN diagnose (⩽2months) and compared them to 1:1 age-matched healthy control group. We measured serum levels of intact FGF23, interleukin-6 (IL-6), tumor necrosis factor α (TNFα), and urinary levels of monocyte chemotactic protein (MCP1).
LN patients (29.5±10years) presented proteinuria of 4.7±2.9g/day, and estimated glomerular filtration rate of 37 (31-87)ml/min/1.73m. They demonstrated higher FGF23 levels when compared to healthy controls [106.7 (80.3-179) vs. 33.6 (25.8-60.9) pg/ml, p<0.001]. FGF23 levels correlated with urinary MCP1 (r=0.62, p<0.001), serum TNFα (r=0.58, p<0.001) and serum IL-6 (r=0.46, p=0.01). Only the correlation between FGF23 and MCP1 remained significant after adjustments for 25(OH) vitamin D and renal function.
Newly diagnosed LN patients demonstrated elevated FGF23 levels that were positively correlated to urinary MCP1, independently of vitamin D levels and kidney function. If FGF23 may predict clinical outcomes in LN warrants further evaluation.
成纤维细胞生长因子23（FGF23）是一种调节磷酸盐的激素，是公认的心血管危险因素。最近，FGF23与炎症有关。狼疮是一种炎症性疾病，FGF23是否与狼疮性肾炎（LN）活动相关尚不清楚。
我们研究了15例近期诊断为LN（≤2个月）的绝经前患者，并将其与年龄匹配的健康对照组按1:1进行比较。我们测量了血清中完整FGF23、白细胞介素-6（IL-6）、肿瘤坏死因子α（TNFα）的水平，以及尿液中单核细胞趋化蛋白（MCP1）的水平。
LN患者（29.5±10岁）的蛋白尿为4.7±2.9g/天，估计肾小球滤过率为37（31 - 87）ml/min/1.73m²。与健康对照组相比，他们的FGF23水平更高[106.7（80.3 - 179）对33.6（25.8 - 60.9）pg/ml，p<0.001]。FGF23水平与尿MCP1（r = 0.62，p<0.001）、血清TNFα（r = 0.58，p<0.001）和血清IL-6（r = 0.46，p = 0.01）相关。在调整25(OH)维生素D和肾功能后，只有FGF23与MCP1之间的相关性仍然显著。
新诊断的LN患者FGF23水平升高，且与尿MCP1呈正相关，与维生素D水平和肾功能无关。FGF23是否可预测LN的临床结局值得进一步评估。
