Muzasti Riri Andri, Lubis Netty Delvrita
Division of Nephrology and Hypertension, Department of Internal Medicine, College of Medicine, Universitas Sumatera Utara, Medan, Indonesia.
Department of Radiology, Adam Malik Hospital, Medan, Indonesia.
Tzu Chi Med J. 2021 Mar 9;33(2):154-159. doi: 10.4103/tcmj.tcmj_2_20. eCollection 2021 Apr-Jun.
Homeostasis of serum phosphorus and calcitriol level is regulated mainly by fibroblast growth factor 23 (FGF23). Studies show that elevated serum FGF23 level was significantly associated with aortic calcification severity, peripheral blood vessels, and a higher score of coronary artery calcification in patients undergoing hemodialysis. We did this cross-sectional study to determine the FGF23 diagnostic value for abdominal aortic calcification in Indonesian hemodialysis patients.
This study included seventy-five, chronic hemodialysis patients. An enzyme-linked immunosorbent assay method was used to measure serum intact FGF23 level, and abdominal aortic calcification was detected by lateral lumbar X-ray. The diagnostic value of FGF23 was analyzed using receiver operating characteristic (ROC) curves.
fifty-one (68.0%) patients had abdominal aortic calcification (AAC). Serum intact FGF23 level ranged from 217 to 950 pg/mL with a median level of 328 pg/mL. The FGF23 levels in the serum of patients with AAC were significantly higher than those without AAC ( < 0.001). The best cutoff point was 277 pg/mL. The calculated area under the ROC curves was 0.959 (95% confidence interval, 0.912-1.00); sensitivity was 94.0% and specificity was 84.0% ( < 0.001).
serum intact FGF23 level may be proposed as a proper tool for abdominal aortic calcification in Indonesian hemodialysis patients.
血清磷和骨化三醇水平的稳态主要由成纤维细胞生长因子23（FGF23）调节。研究表明，血液透析患者血清FGF23水平升高与主动脉钙化严重程度、外周血管以及冠状动脉钙化评分较高显著相关。我们进行了这项横断面研究，以确定FGF23对印度尼西亚血液透析患者腹主动脉钙化的诊断价值。
本研究纳入了75例慢性血液透析患者。采用酶联免疫吸附测定法测量血清完整FGF23水平，并通过腰椎侧位X线检测腹主动脉钙化情况。使用受试者工作特征（ROC）曲线分析FGF23的诊断价值。
51例（68.0%）患者存在腹主动脉钙化（AAC）。血清完整FGF23水平范围为217至950 pg/mL，中位数水平为328 pg/mL。AAC患者血清中的FGF23水平显著高于无AAC患者（<0.001）。最佳截断点为277 pg/mL。计算得出ROC曲线下面积为0.959（95%置信区间，0.912 - 1.00）；敏感性为94.0%，特异性为84.0%（<0.001）。
血清完整FGF23水平可作为印度尼西亚血液透析患者腹主动脉钙化的合适检测指标。
