Mendoza Carrera Francisco, Vázquez Rivera Gloria Elizabeth, Leal Cortés Caridad A, Rizo De la Torre Lourdes Del Carmen, Parra Michel Renato, Orozco Sandoval Rosalba, Pérez Coria Mariana
División de Medicina Molecular, Centro de Investigación Biomédica de Occidente (CIBO), Instituto Mexicano del Seguro Social (IMSS), Guadalajara 44340, Jalisco, Mexico.
División de Investigación Quirúrgica, Centro de Investigación Biomédica de Occidente (CIBO), Instituto Mexicano del Seguro Social (IMSS), Guadalajara 44340, Jalisco, Mexico.
Medicina (Kaunas). 2024 Dec 19;60(12):2081. doi: 10.3390/medicina60122081.
: Uric acid (UA) and the markers of mineral bone metabolism and inflammation are commonly altered in patients with chronic kidney disease (CKD) and are associated with the risk of cardiovascular complications and death. Studies point to a link between high serum UA and mineral bone homeostasis and inflammation, but controversy remains. The aim of this study was to evaluate the relationship between UA levels and mineral bone metabolism and inflammation biomarkers in a sample of Mexican patients with CKD 3a-5. : This cross-sectional study included 146 Mexican patients with CKD 3a-5. In addition, 25 healthy subjects were included in the study with the aim of generating reference data for comparisons. Metabolic parameters including UA serum concentrations, mineral bone metabolism (parathormone (PTH), fibroblast growth factor 23 (FGF23), calcium, and phosphate), and inflammation (interleukin (IL)-1β, IL-6, and tumor necrosis factor-alpha (TNF-α)) biomarkers were measured in all of the samples and compared as a function of the estimated glomerular function rate (eGFR) or UA levels. : Intact PTH, FGF23, and cytokines were higher in advanced CKD stages. Patients with hyperuricemia had significantly higher values of FGF23 and TNF-α compared with those without hyperuricemia. The eGFR was found to be significantly and negatively correlated with all markers. Uric acid was significantly correlated with phosphate, iPTH, FGF23, and TNF-α, whereas iPTH was significantly correlated with FGF23, TNF-α, and FGF23. Finally, a multivariate analysis confirmed the relationship of eGFR with all the tested biomarkers, as well as other relationships of iPTH with UA and TNF-α and of FGF23 with UA and TNF-α. : This study supports the relationship between uric acid and levels of mineral bone metabolism and inflammation biomarkers in patients with CKD at middle to advanced stages. In the follow-up of patients with CKD, monitoring and controlling UA levels through nutritional or pharmacological interventions could help in the prevention of alterations related to mineral bone metabolism.
尿酸（UA）以及矿物质骨代谢和炎症标志物在慢性肾脏病（CKD）患者中通常会发生改变，并与心血管并发症和死亡风险相关。研究指出高血清尿酸与矿物质骨稳态及炎症之间存在联系，但仍存在争议。本研究的目的是评估墨西哥CKD 3a - 5期患者样本中尿酸水平与矿物质骨代谢及炎症生物标志物之间的关系。：这项横断面研究纳入了146名墨西哥CKD 3a - 5期患者。此外，为了生成用于比较的参考数据，研究中还纳入了25名健康受试者。在所有样本中测量了代谢参数，包括血清尿酸浓度、矿物质骨代谢（甲状旁腺激素（PTH）、成纤维细胞生长因子23（FGF23）、钙和磷）以及炎症（白细胞介素（IL）-1β、IL - 6和肿瘤坏死因子-α（TNF - α））生物标志物，并根据估计肾小球滤过率（eGFR）或尿酸水平进行比较。：在CKD晚期，完整PTH、FGF23和细胞因子水平更高。与无高尿酸血症的患者相比，高尿酸血症患者的FGF23和TNF - α值显著更高。发现eGFR与所有标志物均呈显著负相关。尿酸与磷、iPTH、FGF23和TNF - α显著相关，而iPTH与FGF23、TNF - α以及FGF23显著相关。最后，多变量分析证实了eGFR与所有测试生物标志物之间的关系，以及iPTH与尿酸和TNF - α之间以及FGF23与尿酸和TNF - α之间的其他关系。：本研究支持了中晚期CKD患者尿酸与矿物质骨代谢水平及炎症生物标志物之间的关系。在CKD患者的随访中，通过营养或药物干预监测和控制尿酸水平可能有助于预防与矿物质骨代谢相关的改变。
