Effects of cinacalcet treatment on serum soluble Klotho levels in haemodialysis patients with secondary hyperparathyroidism
Effects of cinacalcet treatment on serum soluble Klotho levels in haemodialysis patients with secondary hyperparathyroidism
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DOI：
10.1093/ndt/gfr645
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发表时间：
2012-05-01
影响因子：
6.1
通讯作者：
Fukagawa, Masafumi
中科院分区：
文献类型：
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作者：
Komaba, Hirotaka;Koizumi, Masahiro;Fukagawa, Masafumi
背景资料。Klotho是一种跨膜蛋白，可作为成纤维细胞生长因子23(FGF23)的辅助因子。Klotho也以一种可溶性循环蛋白的形式存在，但其在继发性甲状旁腺功能亢进症(SHPT)中的作用尚不清楚。我们检测了51名血液透析患者的血清可溶性Klotho水平，这些患者参与并完成了一项为期52周的多中心开放单臂试验，该试验检验了Cinacalcet治疗SHPT的有效性。治疗12周后，血清可溶性Klotho显著下降(P<0.03)，但仅从398 pg/m L[四分位数范围(IQR)，268-588 pg/m l]略降至378 pg/m L(IQR，266-568 pg/m l)，并恢复至基线水平。血清钙、磷、全段甲状旁腺激素、FGF23等矿物质代谢指标的变化与血清可溶性Klotho水平的变化无明显相关性。尽管Cinacalcet治疗期间矿物质和骨代谢发生了显著变化，但这只导致血清中可溶性Klotho水平的轻微和短暂下降。
Background. Klotho is a transmembrane protein that acts as a cofactor for fibroblast growth factor 23 (FGF23). Klotho also exists as a soluble circulating protein, but its role in secondary hyperparathyroidism (SHPT) is largely unknown.Methods. We measured serum soluble Klotho levels in 51 haemodialysis patients, who participated and completed a 52-week, multicentre, open-label single-arm trial that examined the effectiveness of cinacalcet for treating SHPT.Results. After 12 weeks of cinacalcet treatment, serum soluble Klotho decreased significantly (P 0.03) but only marginally from 398 pg/mL [interquartile range (IQR), 268-588 pg/mL] to 378 pg/mL (IQR, 266-568 pg/mL) and returned to baseline levels. There were no significant associations between the changes in soluble Klotho levels and changes in any other parameters of mineral metabolism, including serum calcium, phosphorus, intact parathyroid hormone and FGF23.Conclusion. Despite significant alterations in mineral and bone metabolism during treatment with cinacalcet, this resulted in only small and transient reductions in serum levels of soluble Klotho.