血清RANKL、OPG、FGF23与慢性肾脏病患者肾功能及钙磷代谢指标的相关性

Correlation between Serum RANKL,OPG,FGF23 and Renal Function and Calcium-phosphorus Metabolism in Patients with Chronic Renal Disease

目的 分析慢性肾脏病(CKD)患者血清核因子κB受体活化因子配体(RANKL)、骨保护素(OPG)、成纤维细胞生长因子23(FGF23)与肾功能及钙磷代谢指标的相关性。方法 共纳入2021年1月至2022年2月于云南省第一人民医院收治符合CKD诊断标准的患者62例为研究组,并将26名健康体检者纳入对照组。收集肾功能及钙磷代谢相关实验室指标,并通过酶联免疫法测定血清RANKL、OPG、FGF23水平。结果 研究组血清RANKL、OPG、FGF23水平均高于对照组(P <0.05);CKD5期组患者血清RANKL、OPG、FGF23水平高于CKD2-3期组与CKD4期组(P <0.05);血清RANKL、OPG、FGF23水平与eGFR呈负相关性(P <0.05),血清RANKL水平与PTH呈正相关性(P <0.05),血清FGF23水平与PTH、P水平呈正相关性,与Ca呈负相关性(P <0.05)。结论 血清RANKL、OPG、FGF23水平随着CKD患者肾功能进展不断升高,血清RANKL、FGF23是早期发现CKD患者钙磷代谢紊乱的敏感指标。

Objective To analyze the correlation between serum receptor activator of NF-κB ligand(RANKL),osteoprotegerin(OPG),fibroblast growth factor 23(FGF23) with renal function and calcium and phosphorus metabolism in patients with chronic kidney disease(CKD). Methods A total of 62 patients who met the diagnostic criteria of CKD in our hospital from January 2021 to February 2022 were enrolled as the research group, and 26 healthy persons were included in the control group. Renal function and calcium and phosphorus metabolism were measured, and serum levels of RANKL, OPG and FGF23 were measured by enzyme-linked immunosorbent assay(Elisa). Results The serum levels of RANKL,OPG and FGF23 in the research group were significantly increased,and the serum levels of RANKL,OPG and FGF23 in the CKD5 stage group were higher than the CKD2-3 stage group and the CKD4 stage group. Correlation analysis showed that the serum levels of RANKL,OPG and FGF23 were negatively correlated with eGFR,serum RANKL levels were positively correlated with PTH,serum FGF23 levels were positively correlated with PTH and P levels,and negatively correlated with Ca. Conclusions The levels of serum RANKL, OPG and FGF23 are increasing with the progression of CKD disease. Serum RANKL and FGF23 are sensitive indicators for early detection of calcium and phosphorus metabolism disorders in patients with CKD.