VD-FGF23-Klotho轴与糖尿病肾脏疾病进展的相关性  

Correlation Between VD-FGF23-Klotho Axis and the Progress of Diabetic Nephropathy

作　　者：康意 王耀献[1] 刘玉宁[2] 靳茜 周梦琪 李傲霜 吕杰[2] KANG Yi;WANG Yaoxian;LIU Yuning(Beijing University of Chinese Medicine,Beijing 100029;不详)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学东直门医院,北京100700 [3]北京市普仁医院,北京100062

出　　处：《中国中西医结合肾病杂志》2025年第3期208-213,共6页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：国家中医药管理局高水平中医药重点学科建设项目-北京中医药大学-中医肾病学(90010951310022);中医药传承与创新“百千万”人才工程岐黄学者项目(No.RSO032);中央高校基本科研业务专项基金资助项目(No.2023-JYB-JBQN-020);中华中医药学会联合攻关项目(No.2023DYPLHGG-11)。

摘　　要：目的:比较2型糖尿病(diabetes mellitus type 2,T2DM)以及糖尿病肾脏病(diabetic kidney disease,DKD)Ⅲ~Ⅴ期患者血清25(OH)D_(3)、FGF23、Klotho的水平差异,分析三者与DKD患者肾功能和骨代谢指标的相关性,探究三者对DKD病程进展的评估价值。方法:采用横断面调查研究方法,纳入126例T2DM及DKDⅢ~Ⅴ期患者,收集一般资料、血常规、生化全项、骨代谢等相关指标,观察各组间血清25(OH)D_(3)、FGF23、Klotho变化规律及与临床指标的相关性。结果:DKDⅢ~Ⅴ期中,血清25(OH)D_(3)、Klotho含量逐渐降低,FGF23逐渐升高。血清25(OH)D_(3)与CREA、UREA、UA、24 h-UTP、PHOS、ALP、iPTH呈负相关,与eGFR、Ca^(2+)呈正相关;血清FGF23与CREA、UREA、UA、PHOS、iPTH呈正相关,与eGFR呈负相关;血清Klotho与分析指标不存在相关性;血清Klotho/FGF23比值与CREA、UREA、PHOS、iPTH呈负相关,与eGFR呈正相关。结论:血清25(OH)D_(3)、FGF23、Klotho/FGF23比值与DKD的肾功能、骨代谢指标存在相关性,血清25(OH)D_(3)、FGF23可作为DKD矿物质与骨代谢异常的早期监测指标,但血清Klotho在DKD中的预测及评估价值得进一步研究。Objective:To compare the serum levels of 25(OH)D_(3),FGF23 and Klotho in patients with type 2 Diabetes mellitus(T2DM)and Diabetic kidney disease(DKD)stageⅢ~Ⅴ.The correlations of the three indexes with renal function and bone metabolism indexes in DKD patients were analyzed,and the evaluation value of the three indexes for the progression of DKD was explored.Methods:A total of 126 patients with T2DM and DKD stageⅢ~Ⅴwere enrolled in this cross-sectional study.The general data,blood routine,biochemical parameters,bone metabolism and other related indicators were collected.Results:In stageⅢ~Ⅴof DKD,the serum levels of 25(OH)D_(3)and Klotho gradually decreased,while FGF23 gradually increased.Serum 25(OH)D_(3)levels were negatively correlated with CREA,UREA,UA,24 h-UTP,PHOS,ALP,iPTH,and positively correlated with eGFR and Ca^(2+).Serum FGF23 was positively correlated with CREA,UREA,UA,PHOS,iPTH,and negatively correlated with eGFR.There was no correlation between serum Klotho and the analysis indicators.Serum Klotho/FGF23 ratio was negatively correlated with CREA,UREA,PHOS and iPTH,and positively correlated with eGFR.Conclusion:Serum 25(OH)D_(3),FGF23 and Klotho/FGF23 ratio are correlated with renal function,bone metabolism,inflammation and fibrosis indicators in DKD.Serum 25(OH)D_(3)and FGF23 can be used as early monitoring indicators of mineral and bone metabolism abnormalities in DKD.However,the prediction and evaluation of serum Klotho in DKD is worthy of further study.

关 键 词：糖尿病肾脏病 分期 VD-FGF23-Klotho轴 临床指标 相关性 

分 类 号：R587.2[医药卫生—内分泌]