糖尿病肾病患者血浆锶浓度与钙磷代谢的相关性研究

Correlation between plasma strontium concentration and calcium and phosphorus metabolism in patients with diabetic nephropathy

目的探讨糖尿病肾病患者血浆锶(Sr^2+)浓度与钙磷代谢相关指标的关系。方法选择2014年5月至2018年2月收治于解放军第163医院的糖尿病肾病患者500例。收集患者的临床资料以及血清生化指标,根据估算肾小球滤过率(eGFR)对患者进行慢性肾脏病(CKD)分期,并将不同分期的患者分为3组:CKD1~2期、CKD3期、CKD4~5期。采用多元线性回归分析探讨血浆Sr^2+浓度与钙磷代谢指标之间的关系。结果总体研究人群血浆Sr^2+浓度的中位数为269nmol/L,处于正常范围内。CKD1~2期患者的血浆Sr^2+浓度为246nmol/L;CKD3期患者的血浆Sr^2+浓度为347nmol/L;CKD4~5期的患者血浆Sr^2+浓度为419nmol/L。经多元线性回归分析发现,血浆Sr^2+浓度与eGFR(β=-0.411,P<0.01)和血浆成纤维细胞生长因子23(fibroblast growth factor 23,FGF23)浓度(β=0.088,P<0.01)之间存在独立相关。结论糖尿病肾病患者血浆Sr^2+浓度与eGFR水平呈负相关,并且与钙磷代谢指标血浆FGF23浓度独立相关。

Objective To explore the relationship between concentration of plasma strontium (Sr^2+) and parameters of calcium and phosphorus metabolism in patients with diabetic nephropathy. Methods A total of 500 patients with diabetic nephropathy treated in the 163th Hospital of the People's Liberation Army from May 2014 to February 2018 were selected. The clinical data and serum biochemical indicators of the patients were collected, and the patients were classified into different stages of chronic kidney disease (CKD)stages based on estimated glomerular filtration rate (eGFR): CKD stages 1~2, stage 3 and stages 4~5. Multiple linear regression analysis was used to investigate the relationship between plasma Sr^2+ concentration and calcium-phosphorus metabolism. Results The median concentration of plasma Sr^2+ was 269 nmol/L, which was within the normal range. The plasma Sr^2+ concentration in the patients with CKD stages 1~2 was 246 nmol/L;the plasma Sr^2+ concentration in patients with CKD stage 3 was 347 nmol/L;the plasma Sr^2+ concentration in the patients with CKD stages 4~5 was 419 nmol/ L. With the multivariate analysis, plasma Sr^2+ concentrations were found to be independently associated with eGFR (β=-0.411, P <0.01)and plasma fibroblast growth factor 23(FGF23) concentrations (β=0.088, P <0.01). Conclusions In patients with diabetic nephropathy, plasma Sr^2+ concentration has negative correlation with eGFR, and is independently associated with plasma FGF23 concentration.