Elsurer Afsar Rengin, Afsar Baris, Ikizler Talat Alp
Department of Medicine, Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Department of Nephrology, Suleyman Demirel University Faculty of Medicine, Isparta, Turkey.
Kidney Int Rep. 2023 May 3;8(7):1301-1314. doi: 10.1016/j.ekir.2023.04.027. eCollection 2023 Jul.
Protein energy wasting (PEW), mostly characterized by decreased body stores of protein and energy sources, particularly in the skeletal muscle compartment, is highly prevalent in patients with moderate to advanced chronic kidney disease (CKD). Fibroblast growth factor 23 (FGF23) is an endocrine hormone secreted from bone and has systemic actions on skeletal muscle. In CKD, FGF23 is elevated and its coreceptor α-klotho is suppressed. Multiple lines of evidence suggest that FGF23 is interconnected with various mechanisms of skeletal muscle wasting in CKD, including systemic and local inflammation, exaggerated oxidative stress, insulin resistance (IR), and abnormalities in adipocytokine metabolism. Investigation of metabolic actions of FGF23 on muscle tissue could provide new insights into metabolic and nutritional abnormalities observed in patients with CKD.
蛋白质能量消耗（PEW）主要表现为体内蛋白质和能量储备减少，尤其是骨骼肌部分，在中重度慢性肾脏病（CKD）患者中极为普遍。成纤维细胞生长因子23（FGF23）是一种由骨骼分泌的内分泌激素，对骨骼肌具有全身性作用。在CKD中，FGF23升高而其共受体α-klotho被抑制。多条证据表明，FGF23与CKD中骨骼肌消瘦的各种机制相互关联，包括全身和局部炎症、过度氧化应激、胰岛素抵抗（IR）以及脂肪细胞因子代谢异常。研究FGF23对肌肉组织的代谢作用可为CKD患者中观察到的代谢和营养异常提供新的见解。
