Role of fibroblast growth factor-23 in peripheral vascular calcification in non-diabetic and diabetic hemodialysis patients
Role of fibroblast growth factor-23 in peripheral vascular calcification in non-diabetic and diabetic hemodialysis patients
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DOI：
10.1007/s00198-006-0154-6
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发表时间：
2006-10-01
影响因子：
4
通讯作者：
Nishizawa, Y.
中科院分区：
文献类型：
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作者：
Inaba, M.;Okuno, S.;Nishizawa, Y.
成纤维细胞生长因子（FGF）23是最近发现的调节磷酸盐（Pi）代谢的循环因子。由于PI控制紊乱是血管钙化的重要危险因素，我们研究了血浆FGF-23在血液透析患者主动脉和外周动脉血管钙化发展中的重要性，并与糖尿病（DM）。方法：男性血液透析患者DM（n=32）和非DM（n=56）进行了检查。在透析开始前获得血浆样本，并通过酶联免疫吸附测定法测定FGF-23水平。主动脉和手动脉的X线摄影进行了评估，和可见的血管钙化由一个考官，谁是盲目的病人feature.Results：在56例非糖尿病血液透析患者中，血管钙化被发现在手动脉5例（8.9%），在主动脉23例（41.1%）。这些水平显著低于32例糖尿病患者（P < 0.05），其中19例（59.4%）和21例（65.6%）分别有手动脉和主动脉血管钙化。在非DM和DM患者中分别进行的多元回归分析显示，血浆FGF-23水平、CaxPi产物和体重是与手动脉钙化显著相关的独立因素，并且舒张压与非DM患者中的主动脉钙化相关。糖尿病患者血浆FGF-23水平和透析时间是手动脉钙化的独立相关因素，舒张压与主动脉钙化相关。当针对CaxPi产品进行调整时，非DM和DM患者的血浆FGF-23水平与手动脉钙化的独立相关性均得到保留。结论：我们的研究结果表明，在男性非糖尿病和糖尿病血液透析患者中，血浆FGF-23水平是与手动脉中的外周血管钙化负相关的独立因素，但与主动脉中的外周血管钙化无关，即使在调整CaxPi产品时。这项研究提出了一种可能性，即血浆FGF-23水平可能为男性血液透析患者的Moenckeberg中膜钙化提供一个可靠的标志物，独立于其对Pi代谢的调节作用。
Introduction: Fibroblast growth factor (FGF) 23 is a recently identified circulating factor that regulates phosphate (Pi) metabolism. Since the derangement of Pi control is an important risk factor for vascular calcification, we investigated the importance of plasma FGF-23 in the development of vascular calcification in the aorta and peripheral artery in hemodialysis patients with and without diabetes mellitus (DM).Methods: Male hemodialysis patients with DM (n=32) and without DM (n=56) were examined. Plasma samples were obtained before the start of dialysis sessions, and the FGF-23 levels were determined by enzyme-linked immunosorbent assay. Roentgenography of the aorta and hand artery was performed, and visible vascular calcification was evaluated by one examiner, who was blinded to the patient characteristics.Results: In the 56 non-DM hemodialysis patients, vascular calcification was found in the hand artery in 5 patients (8.9%) and in the aorta in 23 patients (41.1%). These levels were significantly lower (p < 0.05) than in the 32 DM patients, of whom, 19 (59.4%) and 21 (65.6%) had vascular calcification of the hand artery and aorta, respectively. Multiple regression analyses performed separately in the non-DM and DM patients showed that the plasma FGF-23 level, CaxPi product, and body weight are independent factors significantly associated with hand-artery calcification and that diastolic blood pressure is associated with aorta calcification in non-DM patients. In DM patients, the plasma FGF-23 level and hemodialysis duration emerged as independent factors associated with hand-artery calcification and diastolic blood pressure was associated with aorta calcification. The independent association of the plasma FGF-23 level with hand-artery calcification was retained in both non-DM and DM patients when adjusted for the CaxPi product.Conclusions: Our findings show that the plasma FGF-23 level is an independent factor negatively associated with peripheral vascular calcification in the hand artery, but not in the aorta, in both male non-DM and DM hemodialysis patients, even when adjusted for the CaxPi product. This study raises the possibility that the plasma FGF-23 level may provide a reliable marker for Moenckeberg's medial calcification in male hemodialysis patients, independent of its regulatory effect on Pi metabolism.