丹参酮胶囊对糖尿病肾病患者成纤维细胞生长因子23-Klotho轴及血管钙化的影响

Effect of Tanshinone Capsule on the Axis of Fibroblast Growth Factor 23-Klotho and Vascular Calcification in Patients with Diabetic Nephropathy

目的通过观察糖尿病肾病(diabetic nephropathy,DN)患者成纤维细胞生长因子23(FGF23)、Klotho蛋白与颈动脉内膜中层厚度(CIMT)的相关性,初步探讨丹参酮胶囊对血管钙化的影响。方法选取DN-Ⅳ期患者71例,随机分为治疗组36例,对照组35例,均予基础治疗,治疗组加用丹参酮胶囊,治疗3个月后比较2组血肌酐(Scr)、钙(Ca)、磷(P)、血清白蛋白(Alb)、总胆固醇(CHOL)、甘油三酯(TG)、全段甲状旁腺激素(i PTH),血清FGF23、Klotho蛋白、TGF-β1、NF-κB、24h尿蛋白定量及C-IMT,选取同时期我院体检中心的健康志愿者35例作为健康对照组。结果治疗组明显降低患者CHOL、TG、血清TGF-β1、NF-κB、FGF23及尿蛋白总量,升高Klotho蛋白水平,抑制CIMT增厚,差异有统计学意义(P<0.05)。Spearman相关系数显示CIMT与尿蛋白定量、FGF-23水平呈正相关,与Klotho蛋白呈负相关(P<0.05)。结论丹参酮通过调控FGF23-Klotho轴改善CIMT,抑制血管钙化,或许与TGF-β1/NF-κB通路存在某种联系。

Objective To observe the correlation of fibroblast growth factor 23（FGF23）,Klotho protein and carotid artery intima media thickness（CIMT） in diabetic nephropathy（DN） patients,and discuss the effect of Tanshinone capsule on vascular calcification. Methods A total of 71 cases of patients with DN stage IV,were randomly divided into treatment group（36 cases）,control group（35 cases）. All patients were treated with basic treatment,and the treatment group was added with Tanshinone capsule,after 3 months,serum creatinine（Scr）,calcium（Ca）,phosphorus（P）,serum albumin（Alb）,total cholestero（lCHOL）,triglyceride（TG）,intact parathyroid hormone（iP TH）,serum FGF23,Klotho protein,TGF-β1,NF-κB,24 hour urinary protein quantitative and CIMT were compared between the two groups,and selected 35 healthy volunteers as healthy control group. Results The treatment group had lower levels of CHOL、TG、serum TGF-β1、NF-κB、FGF23 and urinary protein quantitative,higher levels of Klotho protein,can inhibit CIMT thickening,the difference was statistically significant（P 0.05）. Spearman correlation coefficient showed that CIMT was positively correlated with urinary protein quantitative and FGF23 levels（P〈0.05）,negatively correlated with Klotho protein（P 0.05）. Conclusion Tanshinone capsule can reduce CIMT and inhibit vascular calcification by regulating the FGF23-Klotho axis,may be associated with TGF-β1/NF-κB pathway.