El-Saeed Amany M, El-Mohasseb Ghada F
Department of Clinical Pathology, Faculty of Medicine for girls, Al-Azhar University, Cairo, Egypt.
Department of Internal Medicine, Faculty of Medicine for girls, Al-Azhar University, Cairo, Egypt.
Egypt J Immunol. 2017 Jun;24(2):93-99.
Diabetic nephropathy (DN) is a progressive kidney disease. Previous studies reported that microalbuminuria might not be a sufficient marker to identify diabetic patients at risk of kidney disease progression. Fibroblast growth factors 21 (FGF21) and 23 (FGF23) may play an important role in the DN development and progression. We aimed to assess levels of FGF21 and FGF23 in patients with type 2 diabetes (T2D) with normoalbuminurea, to determine their association with other biochemical parameters and to verify their role as contributing factors to development of DN. The present study included 30 T2D patients with normoalbuminurea (urinary albumin excretion, UAE; less than 30 mg/ 24 hours), and 30 sex and age matched healthy individuals as a control group. Levels of FGF21 and FGF 23 were measured by ELISA. We observed significant increase in FGF21 (P=0.019) and in FGF23 (P=0.000) levels in patients compared with controls. There was a positive correlation between FGF21 and FGF23 and between each of them and other biochemical parameters: cholesterol, triglycerides, LDL cholesterol, FBS, creatinine, HA1C and UAE. Negative correlation was found between both of FGF21 and FGF23 and GFR. We concluded that elevated serum FGF21 and FGF23 levels may be useful biomarkers for predicting kidney disease progression, especially in the early stages of DN.
糖尿病肾病（DN）是一种进行性肾脏疾病。先前的研究报告称，微量白蛋白尿可能不足以作为识别有肾病进展风险的糖尿病患者的标志物。成纤维细胞生长因子21（FGF21）和23（FGF23）可能在DN的发生和发展中起重要作用。我们旨在评估正常白蛋白尿的2型糖尿病（T2D）患者中FGF21和FGF23的水平，确定它们与其他生化参数的关联，并验证它们作为DN发生的促成因素的作用。本研究纳入了30例正常白蛋白尿的T2D患者（尿白蛋白排泄量，UAE；小于30mg/24小时），以及30例性别和年龄匹配的健康个体作为对照组。通过酶联免疫吸附测定法（ELISA）测量FGF21和FGF23的水平。我们观察到与对照组相比，患者的FGF21（P = 0.019）和FGF23（P = 0.000）水平显著升高。FGF21与FGF23之间以及它们各自与其他生化参数：胆固醇、甘油三酯、低密度脂蛋白胆固醇、空腹血糖、肌酐、糖化血红蛋白和UAE之间存在正相关。FGF21和FGF23与肾小球滤过率（GFR）之间均呈负相关。我们得出结论，血清FGF21和FGF23水平升高可能是预测肾病进展的有用生物标志物，尤其是在DN的早期阶段。
