慢性肾脏病患者血清FGF23与颈动脉粥样硬化的相关性研究被引量：5

Association between serum fibroblast growth factor-23 and carotid artery atherosclerosis in patients with chronic kidney disease

暂未订购

导出

摘要目的探讨慢性肾脏病（CKD）3 ～5期患者血清成纤维细胞生长因子23（FGF23）水平和颈动脉粥样硬化的关系.方法选取西丽人民医院CKD患者60例,其中CKD 3～5期非透析组患者30例,维持性血液透析组（MHD） 30例,收集患者资料及相关生化指标,采用酶联免疫吸附法测定所有入组者成纤维蛋白生长因子23（FGF23）;入选患者采用彩色多普勒超声检测颈动脉内中膜厚度（IMT）,比较分析2组各项指标变化的情况,探讨FGF23与颈动脉硬化的相关性及临床意义.结果 ①CKD患者颈动脉粥样硬化发生率较高（25/60,41.6％）,MHD组较非透析组更高（14/30 vs 11/30）,差异有统计学意义（P＜0.01）;②MHD组较非透析组FGF23水平高,差异有统计学意义（P＜0.05）;③pearson相关分析结果显示：CKD患者IMT与收缩压、舒张压、LogFGF23、CRP呈正相关（P＜0.05）,与白蛋白存在负相关关系（P＜0.05）;④多元回归结果显示：血清FGF23水平是CKD患者颈动脉硬化的独立危险因素.结论中晚期CKD患者颈动脉硬化发生率高,血清FGF23与颈动脉粥样硬化的发生相关,可能在动脉粥样硬化的发生发展过程中起着重要作用. Objective To explore the association between serum fibroblast growth factor-23 （FGF23） and carotid artery atherosclerosis in patients with chronic kidney disease （CKD） at stage 3 -5. Methods Sixty patients with CKD were enrolled into this study. Thirty cases were on maintenance hemodialysis（MHD） and 30 were non-dialysis patients. The clinical data was collected. The serum level of FGF23 was measured by ELISA. The carotid artery intima-media thickness and atherosclerotic plaques were assessed by Doppler echocardiography. The indicators mentioned above were compared between the two groups. The association between FGF23 and carotid artery atherosclerosis was studied. Results ①Prevalence of carotid artery atherosclerosis in CKD was high （25/60,41.6%）, and .MHD group was even significantly higher than non-dialysis group（ 14/30 vs. 11/30, P 〈 0.05 ）. ②FGF23 level in MHD group was significantly higher than that in non-dialysis group （P 〈 0.05 ）. ③IMT was positively correlated with systolic blood pressure, diastolic blood pressure, Log- FGF23, C-Reactive protein（CRP） ,P 〈 0. 05 ,while negatively correlated with albumin（ P 〈 0.05 ）. ④the multiple regression analysis showed that the high Log FGF23 -level was an independent risk factor of increased IMT. Conclusion The prevalence of carotid artery atherosclerosis is high in CKD. Serum FGF23 is correlated with MIT in patients with moderate and advanced stage CKD. FGF23 may play an important role in the development of artery atherosclerosis.

作者潘慧娟杨新华镡秋彧孙艳

机构地区广东省深圳市南山区西丽人民医院肾内科

出处《中华全科医学》 2015年第10期1638-1640,1663,共4页 Chinese Journal of General Practice

基金 2012年广东省深圳市科技计划立项项目(201203239)

关键词慢性肾脏病成纤维细胞生长因子23 动脉粥样硬化 Chronic kidney disease Fibroblast growth factor-23 Artery atheroselerosis

分类号 R692 [医药卫生—泌尿科学] R543.4 [医药卫生—心血管疾病]

引文网络
相关文献

参考文献12

1Ramon I,Kleynen P,Body JJ’et al. Fibroblast growth factor 23 and itsrole in phosphate homeostasis[ J]. Eur J Endocrinol,2010,162( 1) :1-10.
2Larsson TE. The role of FGF23 in CKD-MBD and cardiovascular dis-ease friend or foe[J]. [ J]. NDT,2010,25(5) :1376-1381.
3Jean G,Terrat JC,Vanel T,et al. High levels of serum fibroblast growthfactor (FGF) -23 are associated with increased mortality in long haemo-dialysis patients [ J ]. Nephrol Dial Transplant, 2009, 24 (9 ) : 2792-2796.
4Faul C, Amaral AP, Oskouei B, et ai. FGF23 induces left ventricularhypertrophy[ J]. J Clin Invest,2011,121 (11) :4393-4408.
5Miza MA,Hansen T, Johansson L,et al. Ralationship between circulat-ing FGF23 and total body atherosclerosis in the comminity [ J ]. NephrolDial transplant,2009,24(10) :3125-3131.
6Mirza MA,Larsson A,Melhus H,et al. Serum intact FGF23 associated withldt ventricular mass,hypertrophy and geometry in an elderly population[J]. Atherosclerosis,2009,207(2) :546-551.
7李开龙,陈菁,詹俊,王燕,景宇,何娅妮.维持性血液透析患者外周血成纤维细胞生长因子23水平与血管钙化关系的研究[J].中国血液净化,2011,10(2):59-61. 被引量：16
8Miza MA,Larsson A,Lind L,et al. Circulating fibroblast growth factor-23 is associated with vascular dysfunction in community [ J] . Athero-sclerosis, 2009,205 (2) :385-390.
9Donate-Correa J,Mora-Femdndez C,Martlnez-Sanz R,et al. Expressionof FGF23/KL0THO system in human vascular tissue[ J]. Int J Cardiol,2013,165(1):179-183.
10Yilmaz MI,Sonmez AtSaglam M,et al. Longitudinal analysis of vas-cular function and biomarkers of metabolic bone disorders before andafter renal transplantation [ J] . Am J Nephrol,2013, 37 ( 2 ) : 126-134.