Serum fibroblast growth factor-23 levels predict the future refractory hyperparathyroidism in dialysis patients
Serum fibroblast growth factor-23 levels predict the future refractory hyperparathyroidism in dialysis patients
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DOI：
10.1111/j.1523-1755.2005.00184.x
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发表时间：
2005-03-01
影响因子：
19.6
通讯作者：
Fukagawa, M
中科院分区：
文献类型：
--
作者：
Nakanishi, S;Kazama, JJ;Fukagawa, M
背景。继发性甲状旁腺功能亢进是长期透析患者常见的并发症。预测未来甲状旁腺功能的方法尚未建立。成纤维细胞生长因子-23 （FGF-23）是一种新发现的体液磷酸化因子。103例血浆完整甲状旁腺激素（PTH）水平低于300 pg/mL的非糖尿病透析患者纳入研究。血样在-80℃下保存2年。同时，每位负责的医生决定了将完整的甲状旁腺激素水平维持在150 - 300 pg/mL之间的药物治疗策略。患者在样本采集2年后判断甲状旁腺功能亢进是否对药物治疗有反应。难治性继发性甲状旁腺功能亢进的定义是(1)在样本采集2年后保持完整的甲状旁腺激素水平大于300 pg/mL，或(2)在观察期间接受甲状旁腺干预治疗。血清FGF-23水平采用夹心酶联免疫吸附测定系统检测生物活性人FGF-23。17例完整甲状旁腺激素水平大于300 pg/mL的患者被判定为继发性甲状旁腺功能亢进，药物治疗难治性。逐步回归分析显示，只有血清FGF-23水平与甲状旁腺功能的预后有显著关系。受体操作的特征分析表明，从FGF-23（7099.9）获得的曲线下面积明显大于从完整的PTH (6306.4， P
Background. Secondary hyperparathyroidism is a common complication among long-term dialysis patients. The method of predicting future parathyroid function has not yet been established. Fibroblast growth factor-23 (FGF-23) is a newly found humoral phosphaturic factor.Methods. One hundred and three nondiabetic dialysis patients whose plasma intact parathyroid hormone (PTH) levels were below 300 pg/mL were included in the study. Blood samples were stored at -80degreesC for 2 years. Meanwhile, each physician in charge decided upon the strategy of medical therapy for maintaining intact PTH levels between 150 and 300 pg/mL. Patients were judged 2 years after the sample collection with regard to whether the hyperparathyroidism responded to the medical therapy. The definition of refractory secondary hyperparathyroidism was either (1) retaining intact PTH levels greater than 300 pg/mL 2 years after sample collection, or (2) having received the parathyroid intervention therapy during the observation period. Serum FGF-23 levels were determined with a sandwich enzyme-linked immunosorbent assay system that detects biologically active human FGF-23.Results. Seventeen patients with intact PTH levels greater than 300 pg/mL were judged as having secondary hyperparathyroidism refractory to medical therapy. A stepwise regression analysis revealed that only serum levels of FGF-23 were significantly related to the prognosis of parathyroid function. A receiver-operated characteristic analysis demonstrated that the area under the curves obtained from FGF-23 (7099.9) was significantly greater than that obtained from intact PTH (6306.4, P