慢性肾脏病患者成纤维细胞生长因子23、Klotho蛋白与颈动脉内膜中膜厚度的相关性  

Relationship between fibroblast growth factor 23,Klotho protein and carotid intimamedia thickness in patients with chronic kidney disease

作　　者：陈金艳[1] 胡勇[2] 孙红[1] 姜婷 刘先英 CHEN Jin-Yan HU Yong SUN Hong JIANG Ting LIU Xian-Ying(Department of Nephrology Department of Cadre Health Care Department of Scientific Research, the Affiliated Haici Hospital, Qingdao University, Qingdao, Shandong 266001, China)

机构地区：[1]青岛大学附属海慈医院肾病科,山东省青岛市266001 [2]青岛大学附属海慈医院干部保健科,山东省青岛市266001 [3]青岛大学附属海慈医院科研科,山东省青岛市266001

出　　处：《中国动脉硬化杂志》2017年第9期919-922,共4页Chinese Journal of Arteriosclerosis

基　　金：青岛市中医药科研计划(2017-zyx015)

摘　　要：目的探讨慢性肾脏病(CKD)2~5期非透析患者血清成纤维细胞生长因子23(FGF-23)、Klotho蛋白水平与颈动脉粥样硬化程度的关系。方法对126例CKD2~5期患者用彩色超声测定其颈动脉内膜中膜厚度(CIMT),根据CIMT分为CIMT增厚组及CIMT正常组。酶联免疫吸附法测定血清FGF-23、Klotho蛋白水平,收集患者一般资料及临床生化指标。对两组相关指标进行比较,分析FGF-23、Klotho蛋白与颈动脉硬化的相关性。采用非条件Logistic回归分析进行CIMT影响因素的多因素分析。结果 CIMT增厚组血清FGF-23水平明显高于CIMT正常组(435.39±221.20比360.22±194.26,P<0.05),Klotho蛋白水平明显低于CIMT正常组(446.54±132.49比499.36±121.38,P<0.05)。多因素逐步回归分析显示,Klotho蛋白是CKD患者CIMT增厚的独立保护性因素(OR=1.086,P<0.05),而年龄增长、FGF-23是CKD患者CIMT增厚的独立危险因素(OR=1.075,P<0.05;OR=1.238,P<0.05)。结论 CKD2~5期非透析患者CIMT增厚与FGF-23、Klotho蛋白有关,FGF-23、Klotho蛋白在颈动脉硬化的发生发展中起重要作用。Aim To investigate the relationship between serum levels of fibroblast growth factor 23 （ FGF-23）, Klotho protein and carotid atherosclerosis in non-dialysis patients with chronic kidney disease （CKD） 2-5 stage. Meth- otis 126 CKD 2-5 stage patients were involved in the study. Carotid intima-media thickness （CIMT） was measured by color Doppler ultrasonography. The patients were divided into CIMT thickening group and CIMT normal group according to CIMT. Serum levels of FGF-23 and Klotho protein were determined by enzyme-linked immunosorbent assay, and the gen- eral data and clinical biochemical indexes were collected. The relative indexes of the two groups were compared, and the correlation between FGF-23, Klotho protein and carotid atberosclerosis was analyzed. Unconditional Logistic regression a- nalysis was used for multivariate analysis of CIMT influencing factors. Results The serum FGF-23 level in CIMT thickening group was significantly higher than that in CIMT normal group （435.39±221.20 vs 360.22±194.26, P〈0.05 ）, and the level of Klotho protein was significantly lower than that in CIMT normal group （446.54±132.49 vs 499.36±121.38, P〈0.05）. Multivariate stepwise regression analysis showed that Klotho protein was an independent protective factor for CI- MT thickening in patients with CKD （OR= 1.086, P〈0.05）, while age increase and FGF-23 were independent risk factors for CIMT thickening in patients with CKD （ OR = 1.075, P〈0.05; OR= 1.238, P〈0.05）. Conclusion CIMT thicken- ing is related to FGF-23 and Klotho proteins in non-dialysis patients with CKD 2-5 stage. FGF-23 and Klotho protein play an important role in the occurrence and development of carotid athemsclerosis.

关 键 词：慢性肾脏病 成纤维细胞生长因子23 KLOTHO蛋白 颈动脉内膜中膜厚度 

分 类 号：R5[医药卫生—内科学]