Dong Sha-Sha, Che Ruo-Chen, Zheng Bi-Xia, Zhang Ai-Hua, Wang Chun-Li, Bai Mi, Chen Ying
Department of Nephrology, Children's Hospital of Nanjing Medical University, Nanjing 210000, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2023 Jul 15;25(7):705-710. doi: 10.7499/j.issn.1008-8830.2303016.
To study the value of serum fibroblast growth factor 23 (FGF23) in the diagnosis of hypophosphatemic rickets in children.
A total of 28 children who were diagnosed with hypophosphatemic rickets in Children's Hospital of Nanjing Medical University from January 2016 to June 2021 were included as the rickets group. Forty healthy children, matched for sex and age, who attended the Department of Child Healthcare of the hospital were included as the healthy control group. The serum level of FGF23 was compared between the two groups, and the correlations of the serum FGF23 level with clinical characteristics and laboratory test results were analyzed. The value of serum FGF23 in the diagnosis of hypophosphatemic rickets was assessed.
The rickets group had a significantly higher serum level of FGF23 than the healthy control group (<0.05). In the rickets group, the serum FGF23 level was positively correlated with the serum alkaline phosphatase level (=0.38, <0.05) and was negatively correlated with maximum renal tubular phosphorus uptake/glomerular filtration rate (=-0.64, <0.05), while it was not correlated with age, height Z-score, sex, and parathyroid hormone (>0.05). Serum FGF23 had a sensitivity of 0.821, a specificity of 0.925, an optimal cut-off value of 55.77 pg/mL, and an area under the curve of 0.874 in the diagnosis of hypophosphatemic rickets (<0.05).
Serum FGF23 is of valuable in the diagnosis of hypophosphatemic rickets in children, which providing a theoretical basis for early diagnosis of this disease in clinical practice.
探讨血清成纤维细胞生长因子23（FGF23）在儿童低磷性佝偻病诊断中的价值。
选取2016年1月至2021年6月在南京医科大学附属儿童医院确诊为低磷性佝偻病的28例患儿作为佝偻病组。选取同期在该院儿童保健科就诊的40例性别、年龄相匹配的健康儿童作为健康对照组。比较两组血清FGF23水平，并分析血清FGF23水平与临床特征及实验室检查结果的相关性。评估血清FGF23在低磷性佝偻病诊断中的价值。
佝偻病组血清FGF23水平显著高于健康对照组（<0.05）。在佝偻病组中，血清FGF23水平与血清碱性磷酸酶水平呈正相关（=0.38，<0.05），与最大肾小管磷重吸收/肾小球滤过率呈负相关（=-0.64，<0.05），而与年龄、身高Z评分、性别及甲状旁腺激素无相关性（>0.05）。血清FGF23诊断低磷性佝偻病的敏感度为0.821，特异度为0.925，最佳截断值为55.77 pg/mL，曲线下面积为0.874（<0.05）。
血清FGF23对儿童低磷性佝偻病的诊断具有重要价值，为临床早期诊断该病提供了理论依据。
