Abinti Matteo, Vettoretti Simone, Caldiroli Lara, Mattinzoli Deborah, Ikehata Masami, Armelloni Silvia, Molinari Paolo, Alfieri Carlo Maria, Castellano Giuseppe, Messa Piergiorgio
Department of Nephrology, Dialysis and Renal Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy.
J Clin Med. 2024 Jul 6;13(13):3967. doi: 10.3390/jcm13133967.
: In patients with chronic kidney disease (CKD), Fibroblast Growth Factor 23 (FGF23) is markedly increased and has been proposed to interact with systemic inflammation. : In this cross-sectional study, we evaluated the correlations of intact FGF23, c-terminal FGF23, and the FGF23 ratio (c-terminal to intact) with some inflammatory cytokines in 111 elderly patients with advanced CKD not yet in dialysis. : Estimated glomerular filtration rate (eGFR) was inversely correlated with intact FGF23 and c-terminal FGF23, as well as with interleukin 6 (IL-6), tumor necrosis factor alpha (TNFα), and monocyte chemoattractant protein-1 (MCP-1). Intact FGF23 levels were directly correlated with IL-6 (r = 0.403; < 0.001) and TNFα (r = 0.401; < 0.001) while c-terminal FGF23 was directly correlated with MCP-1 (r = 0.264; = 0.005). The FGF23 ratio was, instead, inversely correlated with IL-6 (r = -0.326; < 0.001). Multivariate analysis revealed that intact FGF23 was directly associated with TNFα [B = 0.012 (95% CI 0.006, 0.019); = 0.003] and c-terminal FGF23 was directly associated with MCP-1 [B = 0.001 (95% CI 0.000, 0.002); = 0.038], while the FGF23 ratio was inversely correlated with IL-6 [B = -0.028 (95% CI -0.047, -0.010); = 0.002]. : Our data demonstrate that, in CKD patients, intact FGF23 and the metabolites deriving from its proteolytic cleavage are differently associated with some inflammatory pathways. In particular, intact FGF23 is mainly associated with IL-6 and TNFα, c-terminal FGF23 with MCP-1, and the FGF23 ratio with IL6.
在慢性肾脏病（CKD）患者中，成纤维细胞生长因子23（FGF23）显著升高，并且有人提出它与全身炎症相互作用。在这项横断面研究中，我们评估了111例尚未进行透析的晚期CKD老年患者中完整FGF23、C末端FGF23以及FGF23比值（C末端与完整的比值）与一些炎性细胞因子之间的相关性。估计肾小球滤过率（eGFR）与完整FGF23、C末端FGF23以及白细胞介素6（IL-6）、肿瘤坏死因子α（TNFα）和单核细胞趋化蛋白-1（MCP-1）呈负相关。完整FGF23水平与IL-6（r = 0.403；P < 0.001）和TNFα（r = 0.401；P < 0.001）直接相关，而C末端FGF23与MCP-1直接相关（r = 0.264；P = 0.005）。相反，FGF23比值与IL-6呈负相关（r = -0.326；P < 0.001）。多变量分析显示，完整FGF23与TNFα直接相关[B = 0.012（95%CI 0.006，0.019）；P = 0.003]，C末端FGF23与MCP-1直接相关[B = 0.001（95%CI 0.000，0.002）；P = 0.038]，而FGF23比值与IL-6呈负相关[B = -0.028（95%CI -0.047，-0.010）；P = 0.002]。我们的数据表明，在CKD患者中，完整FGF23及其蛋白水解裂解产生的代谢产物与一些炎症途径的关联不同。特别是，完整FGF23主要与IL-6和TNFα相关，C末端FGF23与MCP-1相关，FGF23比值与IL-6相关。
