摘要
目的:研究Klotho在慢性肾脏病(Chronic Kidney Disease,CKD)患者血清中的变化,探讨其作为CKD早期肾损伤生物标记的意义。方法:回顾收集2013年9月-2014年12月于福建省人民医院就诊的CKD非透析患者130例。分析CKD不同分期患者血清Klotho水平,研究其与全段甲状旁腺激素(iPTH)、成纤维细胞生长因子(FGF23)以及血钙、血磷的相关性。结果:CKD2-5期与CKD1期患者相比,血清Klotho水平降低,且随着CKD的进展,血清Klotho水平逐渐降低(P<0.05);CKD2-5期与CKD1期患者相比,血清FGF23水平升高(P<0.05);且随着CKD的进展,血清FGF23水平逐渐升高(P<0.05);与CKD1期比,CKD3-5期血钙均降低(P<0.05),但各组间血钙水平差异无统计学意义(P>0.05);与CKD1期比,CKD4-5期血磷及钙磷乘积均升高(P<0.05);与CKD3期比,CKD4-5期血磷及钙磷乘积均升高(P<0.05),但两组间血磷及钙磷乘积水平差异无统计学意义(P>0.05);相关分析显示:Klotho与年龄(r=-0.575,P<0.001)、血磷(r=-0.406,P<0.001)、钙磷乘积(r=-0.367,P<0.001)、血清肌酐(r=-0.567,P<0.001)、FGF23(r=-0.616,P<0.001)、iPTH(r=-0.551,P<0.001)呈负相关,与血钙(r=0.242,P=0.005)、表皮生长因子受体(eGFR)(r=0.779,P<0.001)呈正相关;多元逐步线性回归分析显示,eGFR、年龄是血清Klotho水平的主要影响因素。结论:CKD疾病早期患者血清Klotho就开始变化,参与CKD患者iPTH、FGF23以及血钙、血磷水平的调节,因此,Klotho可作为CKD早期肾损伤生物标记物,早期干预血清Klotho的平衡,可能对纠正矿物质代谢紊乱具有一定的意义。
Objective:To study the changes of Klotho in Chronic Kidney Disease patients,and to explore its significance as a biomarker of early Kidney injury in CKD.Methods:130 non-dialysis patients with CKD were retrospectively collected.Serum levels of Klotho in patients with different stages of CKD were analyzed,and their correlation with iPTH,FGF23,blood calcium and blood phosphorus was studied.Results:Compared with patients with CKD1,serum Klotho level of CKD2-5 has decreased,and with the development of CKD,serum Klotho level has gradually decreased(P<0.05).Compared with patients with CKD1 stage,serum FGF23 level has increased(P<0.05).With the development of CKD,serum FGF23 level was gradually increased(P<0.05).Compared with CKD1 stage,blood calcium in CKD3-5 stage was decreased(P<0.05),but there was no statistieally significant difference in blood calcium level between two groups(P>0.05).The product of blood phosphorus and calcium phosphorus in CKD4-5 were increased(P<0.05).The product of blood phosphorus and calcium phosphorus in CKD4-5 were increased compared with that in CKD3 stage(P<0.05),but there was no statistieally significant difference in the product of blood phosphorus and calcium phosphorus between the two groups(P>0.05).Correlation analysis shows that:Klotho with age(r=0.575,P<0.001),blood phosphorus(r=0.406,P<0.001),and the calcium-phosphorus product(r=0.367,P<0.001),serum creatinine(r=0.567,P<0.001),FGF23(r=0.616,P<0.001),iPTH(r=0.551,P<0.001)showed a negative correlation,and the blood calcium(r=0.242,P=0.005),eGFR(r=0.779,P<0.001)were positively correlated.Multiple stepwise linear regression analysis showed that eGFR and age were the main influencing factors of serum Klotho level.Conclusion:Serum Klotho starts to change in patients with early CKD disease,and it is involved in the regulation of iPTH,FGF23,blood calcium and blood phosphorus levels in patients with CKD.Therefore,Klotho can be used as a biomarker for early kidney injury in CKD.Early intervention of serum Klotho balance may be of certain significance for correcting mineral metabolism disorders.
出处
《中医临床研究》
2020年第17期8-13,共6页
Clinical Journal Of Chinese Medicine
