α-Klotho蛋白、FGF-23与糖尿病肾脏病进展相关性临床研究

Clinical Study on the Relationship Betweenα-Klotho Protein,FGF-23 and Progression of Diabetic Kidney Disease

目的:探讨α-Klotho蛋白、FGF-23与糖尿病肾脏病进展相关性。方法:收集2016年04月~2018年05月就诊于北京中医药大学东直门医院等多家肾病中心的糖尿病肾脏病患者,共计127例病例,收集一般临床资料,进行肾功能、血脂等相关检查。依据DKD诊断依据及Mogensen分期等标准,分为三组(早期、中期、晚期),并检测了各组的血清α-Klotho蛋白、FGF-23水平。结果:α-Klotho蛋白在早、中、晚期三组中依次降低,早期和晚期组间差异存在统计学意义(P=0.035);FGF-23在早、中、晚期三组中依次升高,且三组间差异存在统计学意义(P=0.000)。采用Spearman相关分析,eGFR与α-Klotho蛋白存在正相关(r=0.237,P=0.008),eGFR与FGF-23存在负相关(r=-0.605,P=0.000)。24 h尿蛋白定量与FGF-23存在正相关(r=0.552,P=0.000)。结论:Klotho和FGF-23与糖尿病肾脏病的进展相关,有可能成为糖尿病肾脏病疗效评价的生物学标志物之一。

Objective:To investigate the relationship betweenα-Klotho protein,FGF-23 and the progression of Diabetic Kidney Disease.Methods:From April 2016 to May 2018,a total of 127 cases of diabetic kidney disease were collected in Beijing University of Chinese Medicine Dongzhimen Hospital and several kidney centers of other hospitals.Renal function,Blood Lipids and other related tests were administrated.According to DKD diagnostic criteria and Mogensen staging criteria,the patients were divided into three groups(early stage,middle stage and late stage),and the serumα-Klotho protein and FGF-23 levels of each group were detected.Results:α-Klotho protein decreased in turn in the early,middle and late groups,and there were statistical differences between the early and late groups(P=0.035);FGF-23 increased in turn in the early,middle and late groups,and there were statistical differences among the three groups(P=0.000).By Spearman correlation analysis,eGFR was positively correlated withα-Klotho Protein(r=0.237,P=0.008),while eGFR was negatively correlated with FGF-23(r=0.605,P=0.000).There was a positive correlation between 24-hour urinary protein quantification and FGF-23(r=0.552,P=0.000).Conclusion:α-Klotho and FGF-23 are associated with the progression of Diabetic Kidney Disease and may be one of the biomarkers for evaluating the prognosis and curative effect of Diabetic Kidney Disease.