摘要
目的:研究非透析糖尿病肾病(diabetic kidney disease,DKD)患者血清Klotho的变化趋势及与成纤维细胞生长因子23(fibroblast growth factor-23,FGF-23)、钙磷代谢的关系。方法:选取临床诊断为DKD的非透析患者65例及正常人16例作为研究对象。收集研究对象的基础资料及有关生化指标,采用ELISA测定血清Klotho和FGF-23浓度,分析血清Klotho与FGF-23、钙磷相关指标的关系。结果:(1)慢性肾脏病(chronic kidney disease,CKD)1~2期患者血清Klotho高于正常组,随着疾病进展呈下降趋势并逐渐低于正常,且早于高甲状旁腺激素(parathyroid hormone,PTH)、高磷血症、低1,25二羟维生素D3[1,25 dihydroxyvitamin D3,1,25-(OH)2D3]、低钙血症的发生。(2)Spearman相关分析显示血清Klotho与FGF-23(r=0.503)、钙离子(divalent calcium ion,Ca2+)(r=0.384)、估计肾小球滤过率(estimate glomerular filtration rate,eGFR)(r=0.338)、血红蛋白(hemoglobin,Hb)(r=0.384)呈正相关(均P<0.05),与肌酐(creatinine,Cr)(r=-0.345)、24 h尿蛋白(r=-0.425)呈负相关(均P<0.05);多元回归分析示FGF-23、Cr、24 h尿蛋白是影响Klotho的主要因素。结论:DKD患者血清Klotho随着DKD的进展逐渐下降并低于正常,这种变化早于高磷血症、低钙血症、高PTH、低1,25-(OH)2D3的发生,血清Klotho为预测DKD矿物质代谢紊乱的早期生物学标志物。
Objective:To investigate the trend of serum Klotho in patients with diabetic kidney disease(DKD)which have not undergone dialysis.And to analyze the relationship of serum Klotho′s with fibroblast growth factor-23(FGF-23)and calcium-phosphorus metabolism.Methods:65 non-dialysis patients with clinical diagnosis of DKD and 16 normal subjects were selected as the research objects.Collecting the basic data and the biochemical examination indicators of the research object.The concentrations of serum Klotho and FGF-23 were determined by ELISA.Statistics and analysis the relationship between serum Klotho and FGF-23,calcium-phosphorus.Results:(1)Serum Klotho in patients with chronic kidney disease(CKD)stage 1-2 was higher than in the normal group.Serum Klotho shows a downward trend with disease progression and gradually falls below the normal group.This change was earlier than the occurrence of high parathyroid hormone(PTH),hyperphosphatemia,the decrease of 1,25 dihydroxyvitamin D3[1,25-(OH)2D3]and hypocalcemia.(2)Spearman correlation analysis showed that serum Klotho was positively correlated with FGF-23(r=0.503),divalent calcium ion(Ca2+)(r=0.384),estimated glomerular filtration rate(eGFR)(r=0.338),hemoglobin(Hb)(r=0.384)(all P<0.05),and negatively correlated with creatinine(Cr)(r=-0.345)and 24 h urinary protein(r=-0.425)(all P<0.05).Multiple regression analysis showed that FGF-23,Cr and 24 h urinary protein were the main factors affecting Klotho.Conclusion:Serum Klotho in patients with DKD decreased gradually with the progress of DKD and was lower than normal group.This change is earlier than the occurrence of hyperphosphatemia,hypocalcemia,high PTH and low 1,25-(OH)2D3.Serum Klotho is an early biomarker to predict the disorder of mineral metabolism in DKD.
作者
祁月
戴厚永
QI Yue;DAI Houyong(Department of Nephrology,the Affiliated Hospital of Nantong University,Nantong 226001;Department of Nephrology,Jiangsu Province Offical Hospital)
出处
《南通大学学报（医学版）》
2023年第2期144-148,共5页
Journal of Nantong University(Medical sciences)
基金
南通市社会民生科技项目(MS12018045)。
