成纤维细胞生长因子23（Fgf-23）与慢性肾脏病-矿物质和骨异常传统生物标志物之间的相互作用

The Interplay Between Fibroblast Growth Factor-23 (Fgf-23) and Traditional Biomarkers of Chronic Kidney Disease - Mineral and Bone Disorder.

作者信息

Ezeugonwa R S, Bamikefa T A, Ayoola Y A, Sanni I O, Alaya R O, Omotoso B A, Hassan M O, Adamu S, Okunola O O, Sanusi A A, Arogundade F A

机构信息

Department of Medicine, Federal Teaching Hospital, Gombe, Gombe State, Nigeria. Email:

Department of Medicine, College of Health Sciences, Gombe State University, Gombe State, Nigeria.

出版信息

West Afr J Med. 2025 Jan 30;42(1):36-43.

PMID:40544508

Abstract

INTRODUCTION

Chronic kidney disease (CKD) is a global health challenge affecting 11-13% of the world's population. Chronic kidney disease - mineral and bone disorder (CKD-MBD) has been recognized as an important complication of CKD. There has been an increasing interest in fibroblast growth factor 23 (FGF-23), regarding its roles in the pathophysiology, diagnosis, and management of CKD-MBD but its relationship with other biomarkers of CKD-MBD has not been well investigated in sub-Saharan Africa, especially in Nigeria.

METHOD

This study aimed to assess the levels of FGF-23 in patients with kidney disease: Improving Global Outcome (KDIGO) CKD stages 3a to 5 and its relationship with traditional biomarkers of CKD-MBD. One hundred and thirty-eight (138) participants, 103 patients and 35 controls, completed the study. Serum intact parathyroid hormone (iPTH), FGF-23, and calcium among others were measured and a structured, interviewer-administered questionnaire was used to collect data. Data collected were analyzed using the Statistical Package for Social Sciences version 20 (SPSS 20).

RESULTS

The mean serum levels of FGF-23 were different between patients (241.05 ± 3.40pg/ml) and the controls (133.66 ± 2.35pg/ml; p=0.009), and the same applied to the mean serum levels of iPTH for patients and controls (56.15 ± 43.48pg/ml vs 20.11 ± 5.57pg/ml, p = 0.009). The FGF-23 levels increased from stages 3 to 5; however, in stage 5 CKD, those on dialysis had lower iPTH and FGF-23 compared to those who were yet to commence dialysis. In the CKD arm, the calcium-phosphate product had a positive correlation with both FGF-23 and iPTH (r = 0.212; p = 0.01, and r = 0.195; p = 0.022, respectively). The prevalence of CKD-MBD increased as CKD progressed through stages 3 to 5 (72%, 90% and 100% respectively).

CONCLUSION

The prevalence of CKD-MBD was very high in this study, the rate progressively increased as GFR declined. FGF-23 showed a weak correlation with Ca x P product but did not correlate with calcium, phosphate, or iPTH.

摘要

引言

慢性肾脏病（CKD）是一项全球性的健康挑战，影响着全球11%-13%的人口。慢性肾脏病-矿物质和骨异常（CKD-MBD）已被公认为CKD的一种重要并发症。成纤维细胞生长因子23（FGF-23）在CKD-MBD的病理生理学、诊断和管理中的作用受到越来越多的关注，但其与CKD-MBD其他生物标志物的关系在撒哈拉以南非洲地区，尤其是在尼日利亚，尚未得到充分研究。

方法

本研究旨在评估肾病患者（改善全球肾脏病预后组织（KDIGO）CKD 3a至5期）的FGF-23水平及其与CKD-MBD传统生物标志物的关系。138名参与者，包括103名患者和35名对照，完成了本研究。检测了血清全段甲状旁腺激素（iPTH）、FGF-23和钙等指标，并使用一份结构化的、由访谈者实施的问卷收集数据。收集到的数据使用社会科学统计软件包第20版（SPSS 20）进行分析。

结果

患者的FGF-23血清平均水平（241.05±3.40pg/ml）与对照组（133.66±2.35pg/ml；p=0.009）不同，患者和对照组的iPTH血清平均水平情况相同（56.15±43.48pg/ml对20.11±5.57pg/ml，p = 0.009）。FGF-23水平从3期到5期升高；然而，在CKD 5期，透析患者的iPTH和FGF-23低于尚未开始透析的患者。在CKD组中，钙磷乘积与FGF-23和iPTH均呈正相关（分别为r = 0.212；p = 0.01和r = 0.195；p = 0.022）。随着CKD从3期进展到5期，CKD-MBD的患病率增加（分别为72%、90%和100%）。