Fibroblast growth factor 23 is associated with proteinuria and smoking in chronic kidney disease: an analysis of the MASTERPLAN cohort.
Fibroblast growth factor 23 is associated with proteinuria and smoking in chronic kidney disease: an analysis of the MASTERPLAN cohort.
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DOI：
10.1186/1471-2369-13-20
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发表时间：
2012-04-24
期刊：
影响因子：
2.3
通讯作者：
MASTERPLAN group study
中科院分区：
文献类型：
--
作者：
Vervloet MG;van Zuilen AD;Heijboer AC;ter Wee PM;Bots ML;Blankestijn PJ;Wetzels JF;MASTERPLAN group study
成纤维细胞生长因子23（FGF 23）已成为慢性肾脏病（CKD）所有阶段心血管疾病和死亡率的风险因素，独立于已建立的风险因素和矿物质稳态标志物。FGF 23与其他肾脏和非肾脏心血管危险因素的关系尚未完全确定。使用储存的样品，在604名参与MASTERRESISTANCE研究（ISRCTN 73187232）的中度至重度肾病患者中测定血浆FGF 23。使用多变量回归模型评估FGF 23与人口统计学和临床参数的关联。研究人群的平均年龄为60岁，eGFR为37（± 14）ml/min/1.73 m2。中位蛋白尿为0.3 g/24小时[IQR 0.1-0.9]。FGF 23水平中位数和IQR为116 RU/ml [67-203]。采用多变量分析，FGF 23的自然对数与心血管疾病史呈正相关（B = 0.224 RU/ml; p = 0.002），存在糖尿病（B = 0.159 RU/ml; p = 0.035），吸烟（B = 0.313 RU/ml; p < 0.001），磷酸盐水平（B = 0.297/mmol/l; p = 0.0024），lnPTH（B = 0.244/pmol/l; p < 0.001）和蛋白尿（B = 0.064/g/24小时; p = 0.002），与eGFR呈负相关（B = -0.022/ml/min/1.73 m2; p < 0.001）。我们的研究表明，在CKD患者中，FGF 23与蛋白尿和吸烟有关。我们证实了FGF 23与其他心血管危险因素之间的关系。
Fibroblast growth factor 23 (FGF23) has emerged as a risk factor for cardiovascular disease and mortality throughout all stages of chronic kidney disease (CKD), independent from established risk factors and markers of mineral homeostasis. The relation of FGF23 with other renal and non-renal cardiovascular risk factors is not well established. Using stored samples, plasma FGF23 was determined in 604 patients with moderate to severe kidney disease that participated in the MASTERPLAN study (ISRCTN73187232). The association of FGF23 with demographic and clinical parameters was evaluated using multivariable regression models. Mean age in the study population was 60 years and eGFR was 37 (± 14) ml/min/1.73 m2. Median proteinuria was 0.3 g/24 hours [IQR 0.1-0.9]. FGF23 level was 116 RU/ml [67-203] median and IQR. Using multivariable analysis the natural logarithm of FGF23 was positively associated with history of cardiovascular disease (B = 0.224 RU/ml; p = 0.002), presence of diabetes (B = 0.159 RU/ml; p = 0.035), smoking (B = 0.313 RU/ml; p < 0.001), phosphate level (B = 0.297 per mmol/l; p = 0.0024), lnPTH (B = 0.244 per pmol/l; p < 0.001) and proteinuria (B = 0.064 per gram/24 hrs; p = 0.002) and negatively associated with eGFR (B = -0.022 per ml/min/1.73 m2; p < 0.001). Our study demonstrates that in patients with CKD, FGF23 is related to proteinuria and smoking. We confirm the relation between FGF23 and other cardiovascular risk factors.