关键词: 维持性血液透析, 成纤维细胞生长因子23, 冠状动脉钙化, 腹主动脉钙化, 左心室质量指数, 左心室肥厚

Abstract:

Abstract Objective: To determine the serum levels of fibroblast growth factor (FGF23) and to explore the relationships of FGF23 with vascular calcification and left ventricular hypertrophy (LVH) in patients with maintenance hemodialysis (MHD). Methodology: A cross-sectional observation on one hundred eighty two patients with MHD was performed in this study. The serum intact FGF23, serum calcium and phosphorus, intact parathyroid hormone (iPTH), 25 hydroxy vitamin D, and routine laboratory examination index were examined.  The agents for regulating the metabolism of calcium and phosphorus were recorded. Patients undergone spiral CT to get coronary calcification score (CACS), abdominal lateral plain film examine to get abdominal aortic calcification score (AACS), and cardiac ultrasound examine to get cardiac indexs. Results: The levels of serum FGF23 were significantly increased in our patients with MHD. According to the levels of FGF23, the patients were divided into four groups. With the increasing levels of FGF23, the patients were older, ankle brachial index was lower, hemoglobin was lower, and serum phosphorus was higher (p＜0.05). The correlation coefficient of serum FGF23 and serum phosphorus was 0.435（p=0.001）. The levels of serum 25 (OH) D showed a decreasing trend, while lgiPTH, prescription of vitamin D, Left ventricular mass index（LVMI）, the prevalence of left ventricular hypertrophy (LVH) showed an increasing trend, but the difference was not statistically significant. In addition to the patients with AACS≥5, the prevalence of abdominal aortic calcification was increased with FGF23 elevation (P=0.048), the prevalence and severity of vascular calcification of the other groups had a rising trend, but the difference was not statistically significant. Conclusion: The levels of serum FGF23 were increased significantly in patients with, which was related with the increasing levels of serum phosphorus. No relationships of serum FGF23 levels with coronary artery calcification and prevalence of LVH was found, except the patients with abdominal aorta calcification（AACS≥5）.
 

Key words: maintenance hemodialysis, fibroblast growth factor 23, coronary artery calcification, abdominal aortic calcification, left ventricular hypertrophy