Association between fibroblast growth factor 23 and bone metabolism in peritoneal dialysis patients / 中华肾脏病杂志

ABSTRACT

Objective To explore the association between fibroblast growth factor 23 (FGF-23) and calcium (Ca)-phosphorus(P) metabolism and bone mineral density (BMD) in patients on peritoneal dialysis.Methods Fifty-nine patients undergoing continuous ambulatory peritoneal dialysis(CAPD) were enrolled in this study.These patients were divided into three groups as normal, osteopenic and osteoporotic, according to World Health Organization criteria based on bone mineral density T scores.Another 30 healthy people were also enrolled as control group.Levels of serum FGF-23 and 1,25 (OH)2VitD3 were measured by ELISA.Parathyroid horomone(PTH) was detected by immunoradiometric assay.Calcium and phosphorus were assessed with autobiochemistry machine.Bone density was studied by dual-energy X-ray absorptiometry (DEXA).Results The incidences of osteoporosis at the femur neck and lumbar spine in CAPD patients were 23.7％ and 35.6％, respectively.Among three groups of CADP patients, no significant differences were found in the levels of serum FGF-23, while the level of serum FGF-23 in CAPD group was higher than that in control gronp(P＜0.01).A positive correlation was found between log [FGF-23]and serum phosphorus(r=0.604, P＜0.01).However, a negative correlation was found between log[FGF-23]and 1,25(OH)2VitD3 and GFR (r=-0.401, P＜0.05; r=-0.651, P＜0.01).There were no correlations of log [FGF-23]with PTH, Ca, T scores and the duration of dialysis.Conclusions In CAPD patients, serum FGF-23 increases significantly.Serum phosphorus, renal function and 1,25(OH)2VitD3may play an important role in adjusting the level of serum FGF-23, while FGF-23 has no direct effect on bone mineralization in CAPD patients.