Yamamoto Shogo, Koyama Daisuke, Igarashi Ryo, Maki Takumi, Mizuno Hiroyuki, Furukawa Yusuke, Kuro-O Makoto
Department of Internal Medicine, Fukushima Prefectural Miyashita Hospital, Japan.
Division of Stem Cell Regulation, Center for Molecular Medicine, Jichi Medical University, Japan.
Intern Med. 2020;59(3):345-355. doi: 10.2169/internalmedicine.3597-19. Epub 2020 Feb 1.
Objective To prolong the health expectancy, it is important to prevent age-related diseases, such as osteoporosis and cerebrovascular disease, which are major causes of a bedridden state. Early predictable biomarkers for these diseases are urgently required in the clinical setting. Three members of the fibroblast growth factor (FGF) family - FGF19, FGF21, and FGF23 - are designated as endocrine FGFs and play crucial roles in various metabolic processes. We tried to clarify the clinical utility of endocrine FGFs as biomarkers for age-related diseases in elderly patients. Methods We examined the serum endocrine FGF levels and analyzed their association with various clinical parameters in 73 outpatients >60 years old as a single-center cross-sectional study. Results In a multivariable linear regression analysis, FGF19 was associated with ALT, a history of cardiovascular disease, and medication with active vitamin D. FGF21 was associated with the estimated glomerular filtration rate (eGFR), triglyceride level, and hypertension. FGF23 was associated with the eGFR and the serum levels of 1,25-dihydroxy vitamin D and TRACP5b. In addition, a receiver operating characteristics analysis revealed that the measurement of FGF21 and FGF23 was useful for detecting chronic kidney disease (CKD) and its complications, including cardiovascular disease and metabolic bone disorder. Conclusion The measurement of FGF21 and FGF23 may be useful for evaluating CKD and its complications. Using serum endocrine FGFs as biomarkers for age-related conditions may help prevent elderly patients from entering a bedridden state.
目的 为延长健康预期寿命，预防与年龄相关的疾病（如骨质疏松症和脑血管疾病，这些是导致卧床状态的主要原因）至关重要。临床环境迫切需要这些疾病的早期可预测生物标志物。成纤维细胞生长因子（FGF）家族的三个成员——FGF19、FGF21和FGF23——被指定为内分泌FGF，在各种代谢过程中发挥关键作用。我们试图阐明内分泌FGF作为老年患者与年龄相关疾病生物标志物的临床效用。方法 作为一项单中心横断面研究，我们检测了73名60岁以上门诊患者的血清内分泌FGF水平，并分析了它们与各种临床参数的关联。结果 在多变量线性回归分析中，FGF19与谷丙转氨酶、心血管疾病史以及活性维生素D用药有关。FGF21与估计肾小球滤过率（eGFR）、甘油三酯水平和高血压有关。FGF23与eGFR以及1,25-二羟基维生素D和抗酒石酸酸性磷酸酶5b（TRACP5b）的血清水平有关。此外，受试者工作特征分析表明，检测FGF21和FGF23有助于检测慢性肾脏病（CKD）及其并发症，包括心血管疾病和代谢性骨病。结论 检测FGF21和FGF23可能有助于评估CKD及其并发症。将血清内分泌FGF用作与年龄相关疾病的生物标志物可能有助于防止老年患者进入卧床状态。
