Diabetes Therapeutics and Research Center, Institute of Advanced Medical Sciences, Tokushima University, Tokushima, Japan.
Fujii Memorial Institute of Medical Sciences, Institute of Advanced Medical Sciences, Tokushima University, Tokushima, Japan.
J Bone Miner Metab. 2020 Jan;38(1):70-77. doi: 10.1007/s00774-019-01027-7. Epub 2019 Aug 16.
Fibroblast growth factor (FGF) 23 is a bone-derived hormone regulating serum inorganic phosphate (Pi) concentration. FGF23 is also involved in the development of chronic kidney disease (CKD)-mineral and bone disorder. Serum FGF23 concentration begins to increase early in the progression of CKD and can be remarkably high in hemodialysis patients with end-stage renal disease. It has been reported that high FGF23 concentration is a risk factor for cardiac dysfunction, atherosclerosis, infection or systemic inflammation in CKD patients. FGF23 was also shown to induce cardiac hypertrophy directly acting on cardiomyocytes. However, it is still controversial whether high FGF23 is causing cardiac dysfunction, atherosclerosis, infection or systemic inflammation in CKD patients. In the current study, we investigated whether FGF23 concentration is associated with cardiac dysfunction, atherosclerosis, infection or systemic inflammation in Japanese hemodialysis patients. We recruited 119 hemodialysis patients and examined the association between serum FGF23 concentration and several parameters concerning mineral metabolism, cardiac dysfunction, atherosclerosis, infection, and systemic inflammation. Serum FGF23 concentration was independently associated with serum calcium and Pi concentration (β = 0.276, p < 0.001; β = 0.689, p < 0.001). However, serum FGF23 concentration was not associated with parameters of cardiac dysfunction, atherosclerosis, infection, and systemic inflammation, either. Our results do not support the hypothesis that high FGF23 in dialysis patients is the cause of cardiac dysfunction, atherosclerosis, infection or systemic inflammation.
成纤维细胞生长因子 23（FGF23）是一种由骨骼分泌的激素，可调节血清无机磷（Pi）浓度。FGF23 还参与慢性肾脏病（CKD）-矿物质和骨异常的发生发展。在 CKD 的进展早期，血清 FGF23 浓度开始升高，在终末期肾病的血液透析患者中可能会显著升高。有报道称，高 FGF23 浓度是 CKD 患者心功能障碍、动脉粥样硬化、感染或全身炎症的危险因素。FGF23 还被证明可通过直接作用于心肌细胞诱导心肌肥大。然而，高 FGF23 是否导致 CKD 患者心功能障碍、动脉粥样硬化、感染或全身炎症仍存在争议。在本研究中，我们调查了日本血液透析患者中 FGF23 浓度与心功能障碍、动脉粥样硬化、感染或全身炎症之间的关系。我们招募了 119 名血液透析患者，并检查了血清 FGF23 浓度与矿物质代谢、心功能障碍、动脉粥样硬化、感染和全身炎症等几个参数之间的关系。血清 FGF23 浓度与血清钙和 Pi 浓度独立相关（β=0.276，p<0.001；β=0.689，p<0.001）。然而，血清 FGF23 浓度与心功能障碍、动脉粥样硬化、感染和全身炎症的参数也没有相关性。我们的结果不支持透析患者中高 FGF23 是心功能障碍、动脉粥样硬化、感染或全身炎症的原因的假说。
