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目的探讨成纤维细胞生长因子23(fibroblast growth factor-23,FGF23)与持续性非卧床腹膜透析(continuous ambulatory peritoneal dialysis,CAPD)患者腹主动脉钙化之间的相关性。方法收集2013-07-01—2014-03-01在中国医科大学附属第一医院及辽宁省人民医院接受腹膜透析治疗时间>3个月,病情平稳的CAPD患者58例的临床资料及血生化指标,应用酶联免疫吸附试验(ELISA)测定血清中FGF23水平,腹部侧位平片测定腹主动脉钙化(abdominal aortic calcification,AAC)评分情况,采用Pearson相关性分析方法分析FGF23与AAC评分之间的相关性,采用多元线性回归分析FGF23浓度、临床生化指标和AAC之间的关系。以腹主动脉重度钙化(AAC≥16赋值为1)作为因变量,应用Logistic回归分析方法分析CAPD患者发生腹主动脉重度钙化的危险因素。结果 58例CAPD患者中有50例发生腹主动脉钙化,钙化发生率为86.2%。血清FGF23的浓度为(157.89±46.23)ng/L。FGF23与AAC评分呈正相关(r=0.403,P<0.05),与骨特异性碱性磷酸酶(bone-specific alkaline phosphatase,BAP)呈正相关(r=0.71,P<0.05),与血磷、全段甲状旁腺素(iPTH)、血钙、25-羟维生素D无显著相关性。多元线性回归分析显示,FGF23与AAC无相关性(r=-0.47,P=0.96)。Logistic回归分析显示,血清FGF23升高是CAPD患者发生腹主动脉重度钙化的危险因素(β=0.069,OR=1.071,P<0.05)。结论血清FGF23浓度升高是CAPD患者发生腹主动脉重度钙化的危险因素。
Objective To investigate the correlation between fibroblast growth factor-23 (FGF23) and calcification of abdominal aorta in patients with continuous ambulatory peritoneal dialysis (CAPD). Methods Collecting 2013-07-01-2014-03-01 In the First Affiliated Hospital of China Medical University and Liaoning Provincial People’s Hospital peritoneal dialysis treatment time> 3 months, 58 patients with stable disease CAPD clinical data and blood biochemical indicators Serum levels of FGF23 were measured by enzyme-linked immunosorbent assay (ELISA), abdominal aortic calcification (AAC) score was measured by lateral plain radiographs, Pearson correlation analysis was used to analyze the relationship between FGF23 and AAC score Correlation, the use of multiple linear regression analysis of FGF23 concentration, clinical and biochemical markers and the relationship between AAC. With the severe calcification of abdominal aorta (AAC≥16 assigned as 1) as the dependent variable, Logistic regression analysis was used to analyze the risk factors of severe calcification of abdominal aorta in CAPD patients. Results Fifty-eight CAPD patients had abdominal aorta calcification and the rate of calcification was 86.2%. Serum FGF23 concentration was (157.89 ± 46.23) ng / L. FGF23 was positively correlated with AAC score (r = 0.403, P <0.05) and positively correlated with bone specific alkaline phosphatase (BAP) (r = 0.71, P <0.05) Parathyroid hormone (iPTH), serum calcium, 25-hydroxyvitamin D no significant correlation. Multivariate linear regression analysis showed no correlation between FGF23 and AAC (r = -0.47, P = 0.96). Logistic regression analysis showed that elevated serum FGF23 was a risk factor for severe calcification of abdominal aorta in patients with CAPD (β = 0.069, OR = 1.071, P <0.05). Conclusion Serum FGF23 concentration is a risk factor for severe calcification of abdominal aorta in CAPD patients.