Amsterdam University Medical Center, Department of Nephrology, and Amsterdam Cardiovascular Sciences (ACS), Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.
Clin Chim Acta. 2020 Jun;505:160-166. doi: 10.1016/j.cca.2020.03.013. Epub 2020 Mar 7.
Fibroblast growth factor can be measured in clinical practice using ELISA, with acceptable validity. Different from many metabolites and minerals, its value can differ by a thousand-fold between individuals, largely because of differences in kidney function and dietary habits. This wide range complicates the proper interpretation of the concentration of FGF23, both in terms of the appropriateness of a given value for a given estimated GFR, and in terms of estimating the magnitude of risk for clinical events, with which FGF23 is clearly associated. In this narrative review, the impact of kidney function, exposure to phosphate from diet, and novel emerging factors that influence FGF23 concentrations are discussed. These and yet to define determinants of FGF23 question the causality of the association of FGF23 with hard (cardiovascular) endpoints, as observed in several epidemiological studies.
成纤维细胞生长因子（FGF23）可通过 ELISA 在临床实践中进行测量，其具有可接受的有效性。与许多代谢物和矿物质不同，其在个体之间的差异可达千倍，这主要是由于肾功能和饮食习惯的差异所致。这种广泛的差异使得 FGF23 浓度的正确解释变得复杂，无论是对于特定估算肾小球滤过率（eGFR）下的特定值的适当性，还是对于估计与 FGF23 明显相关的临床事件风险的大小而言都是如此。在本叙述性综述中，讨论了肾功能、饮食中磷酸盐暴露以及影响 FGF23 浓度的新出现因素的影响。这些和尚未确定的 FGF23 决定因素，对观察到的几种流行病学研究中 FGF23 与硬性（心血管）终点之间的关联的因果关系提出了质疑。
