Unit of Paediatric Hematology and Oncology, Chorzow City Hospital, Chorzow, Poland; Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland.
Physiol Res. 2020 Jul 16;69(3):451-460. doi: 10.33549/physiolres.934307. Epub 2020 May 29.
Fibroblast growth factor 21 (FGF21) is one of the members of endocrine arm of FGF family. Its actions as a glucose and lipids metabolism regulator are widely known. Although the mechanism of FGF21 action in kidneys is still under investigation, FGF21 was considered as a marker of early kidney function decline. While many researchers focused on adult subjects in this matter, there are no data regarding children. Therefore, we have investigated the relationship between plasma or urine FGF21 levels and kidney function in a group of 42 pediatric patients with chronic kidney disease (CKD). Anthropometrical parameters and blood pressure were taken, routine biochemical tests were performed. The concentration of FGF21 in serum and urine was determined by enzyme immunoassay. The results revealed significantly higher serum FGF21 concentration among children from CKD group. However, serum FGF21 level was not related to gender, proteinuria, eGFR or renal replacement therapy. Urine FGF21 concentration correlated negatively with albuminuria and positively with eGFR. Documented negative correlation of FGF21 fractional excretion and eGFR is not enough to support the role of FGF21 as a biomarker for predicting kidney disease progression in children and adolescents. Other mechanisms including local kidney FGF21 production or enhanced excretion due to higher extrarenal production may result in higher urine FGF21 concentrations.
成纤维细胞生长因子 21（FGF21）是成纤维细胞生长因子家族内分泌臂的成员之一。它作为葡萄糖和脂质代谢调节剂的作用是众所周知的。尽管 FGF21 在肾脏中的作用机制仍在研究中，但 FGF21 被认为是早期肾功能下降的标志物。虽然许多研究人员在这方面关注的是成年受试者，但针对儿童的数据却没有。因此，我们研究了在一组 42 名患有慢性肾脏病（CKD）的儿科患者中，血浆或尿液 FGF21 水平与肾功能之间的关系。测量了人体测量参数和血压，进行了常规生化测试。通过酶联免疫吸附法测定血清和尿液中 FGF21 的浓度。结果显示，CKD 组儿童的血清 FGF21 浓度显著升高。然而，血清 FGF21 水平与性别、蛋白尿、eGFR 或肾脏替代治疗无关。尿 FGF21 浓度与白蛋白尿呈负相关，与 eGFR 呈正相关。FGF21 分数排泄与 eGFR 的负相关不足以支持 FGF21 作为预测儿童和青少年肾脏病进展的生物标志物的作用。其他机制，包括局部肾脏 FGF21 产生或由于更高的肾外产生导致的增强排泄，可能导致更高的尿 FGF21 浓度。
