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FGF-23, Inflammation and Iron Metabolism in The Early Stages of Autosomal Dominant Polycystic Kidney Disease

Yıl 2020, Cilt: 42 Sayı: 2, 195 - 202, 17.03.2020
https://doi.org/10.20515/otd.540614

Öz

To investigate the correlation of
Fibroblast Growth Faktör-23 (sFGF-23) with iron status, inflammation and
carotid intima-media thickness (CIMT) in the early stages of autosomal dominant
polycystic kidney disease (ADPKD). Forty ADPKD patients (24 female) with normal
creatinine levels and 40 healthy volunteers (21 female) were included in the
study. Serum FGF-23 levels were measured using the ELISA technique. The
associations between sFGF-23 with CIMT, hs-CRP, neutrophil lymphocyte ratio
(NLR) and iron parameters were evaluated using correlation analysis. Patients’
sFGF-23 levels were significantly higher [245 (182-963) pg/mL; vs. 219.6
(34-494) pg/mL], (P< 0.001). NLR and hs-CRP were also found to be
statistically higher in patients than controls (P< 0.001 and P= 0.003,
respectively). CIMT was significantly higher in the patient group (P= 0.037).
There were statistically significant negative correlations between sFGF-23 and
calcium, hemoglobin, hematocrit, serum iron, ferritin, and NLR (P= 0.009, P=
0.035, P= 0.002, P= 0.033, P= 0.017, P= 0.023, respectively), and positive
correlations with phosporus, total iron binding capacity and sFGF-23 (P= 0.010,
P= 0.049, respectively). There was no statistically significant correlation
between sFGF-23 and PTH, hs-CRP and CIMT. In multivariate lineer regression
analysis, serum phosphorus level was statistically significiant independent
risk factor for the determinantion of sFGF-23 level [B: 0.318,
OR:130,662(32,715-228,610), P=0.010]. Our study results support an inverse relationship
between sFGF-23 and iron deficiency but no relationship between sFGF-23 and
inflammation and atherosclerosis in the early stages of ADPKD.

Kaynakça

  • References:1. Isakova T, Wahl P, Vargas GS, et al. Fibroblast growth factor 23 is elevated before parathyroid hormone and phosphate in chronic kidney disease. Kidney international. 2011;79:1370–1378.
  • 2. Lukaszyk E, Lukaszyk M, Koc-Zorawska E, Bodzenta-Lukaszyk A, Malyszko J. Fibroblast growth factor 23, iron and inflammation are they related in early stages of chronic kidney disease? Arch Med Sci. 2017;13, 4: 845–850
  • 3. Masanobu Kawai. The FGF23/Klotho axis in the regulation of mineral and metabolic homeostasis. Horm Mol Biol Clin Invest. 2016;28(1): 55–67
  • 4. Scialla JJ, Xie H, Rahman M, et al.; Chronic Renal Insufficiency Cohort (CRIC) Study Investigators. Fibroblast growth factor-23 and cardiovascular events in CKD. J Am Soc Nephrol. 2014;25: 349-60.
  • 5. Mirza MA, Larsson A, Melhus H, Lind L, Larsson TE. Serum intact FGF23 associate with left ventricular mass, hypertrophy and geometry in an elderly population. Atherosclerosis. 2009;207: 546-51.
  • 6. Kocaman O, Oflaz H, Yekeler E, et al. Endothelial dysfunction and increased carotid intima-media thickness in patients with autosomal dominant polycystic kidney disease. Am J Kidney Dis, 2004;43: 854-60.
  • 7. Pavik I, Jaeger P, Kistler AD, et al. Patients with autosomal dominant polycystic kidney disease have elevated fibroblast growth factor 23 levels and a renal leak of phosphate. Kidney Int. 2011; 79: 234-40.
  • 8. Munoz Mendoza J, Isakova T, Ricardo AC, et al.; Chronic Renal Insufficiency Cohort. Fibroblast Growth Factor 23 and Inflammation in CKD. Clin J Am Soc Nephrol. 2012;Jul;7(7):1155-62.
  • 9. Menon V, Rudym D, Chandra P, Miskulin D, Perrone R, Sarnak M. Inflammation, oxidative stress, and insulin resistance in polycystic kidney disease. Clin J Am Soc Nephrol. 2011;6:7-13.
  • 10. Imel EA, Peacock M, Gray AK, Padgett LR, Hui SL, Econs MJ. Iron modifies plasma FGF23 differently in autosomal dominant hypophosphatemic rickets and healthy humans. J Clin Endocrinol Metab. 2011;96:3541–9.
  • 11. Braithwaite V, Prentice AM, Doherty C, Prentice A. FGF23 is correlated with iron status but not with inflammation and decreases after iron supplementation: a supplementation study. Int J Pediatr Endocrinol 2012;Oct 26 (1):27.
  • 12. Wolf M, White KE. Coupling fibroblast growth factor 23 production and cleavage: iron deficiency, rickets, and kidney disease. Curr Opin Nephrol Hypertens 2014;23: 411-9
  • 13. Spichtig D, Zhang H, Mohebbi N, et al. Renal expression of FGF23 and peripheral resistance to elevated FGF23 in rodent models of polycystic kidney disease. Kidney Int. 2014;85:1340-50
  • 14. Pavik I, Jaeger P, Ebner L, et al. Soluble klotho and autosomal dominant polycystic kidney disease. Clin J Am Soc Nephrol. 2012;7:248-57.
  • 15. Yildiz A, Gul CB, Ersoy A, et al. Arterial Dysfunction in Early Autosomal Dominant Polycystic Kidney Disease Independent of Fibroblast Growht Factor 23, Iranian Journal of Kidney Diseases. 2014;8; 443-9.
  • 16. Turkmen K, Tufan F, Selçuk E, Akpınar T, Oflaz H, Ecder T. Neutrophil-to-lymphocyte ratio, insulin resistance, and endothelial dysfunction in patients with autosomal dominant polycystic kidney disease. Indian J Nephrol. 2013;23:34-40.
  • 17. Abdallah E, Mosbah O, Khalifa G, Metwaly A, El-Bendary O. Assessment of the relationship between serum soluble Klotho and carotid intimaemedia thickness and left ventricular dysfunction in hemodialysis patients. Kidney Res Clin Pract 2016;35(1): 42-49
  • 18. David V, Martin A, Isakova T, et al. Inflammation and functional iron deficiency regulate fibroblast growth factor 23 production. Kidney Int. 2016;89(1):135–146.
  • 19. Holecki M, Chudek J, Owczarek A, et al. Inflammation but not obesity or insulin resistance is associated with increased plasma fibroblast growth factor 23 concentration in the elderly. Clin Endocrinol 2015;82(6):900–909
  • 20. Munoz Mendoza J, Isakova T, Ricardo AC, et al. Chronic Renal Insufficiency Cohort. Fibroblast growth factor 23 and Inflammation in CKD. Clin J Am Soc Nephrol 2012;7(7):1155–1162
  • 21. Hryszko T, Rydzewska-Rosolowska A, Brzosko S, Koc-Zorawska E, Mysliwiec M. Low molecular weight iron dextran increases fibroblast growth factor-23 concentration, together with parathyroid hormone decrease in hemodialyzed patients. Ther Apher Dial 2012;16(2):146–151
  • 22. Block GA, Fishbane S, Rodriguez M, et al. A 12-week, double-blind, placebo-controlled trial of ferric citrate for the treatment of iron deficiency anemia and reduction of serum phosphate in patients with CKD stages 3–5. Am J Kidney Dis 2015;65(5):728–736
  • 23. Prats M, Font R, Garcia C, Cabré C, Jariod M, Vea AM. Effect of ferric carboxymaltose on serum phosphate and C-terminal FGF23 levels in non-dialysis chronic kidney disease patients: post hoc analysis of a prospective study. BMC Nephrol 2013;14:167
  • 24. Imel EA, Liu Z, McQueen AK, et al. Serum fibroblast growth factor 23, serum iron and bone mineral density in premenopausal women. Bone 2016; 86:98–105
  • 25. Eser B, Yayar O, Buyukbakkal M, et al. The Fibroblast growth factor is associated to left ventricularmass index, anemia and low values of transferrin saturation. Nephrologia. 2015;35(5):465-72.

Erken Evre Otozomal Dominant Polikistik Böbrek Hastalığında FGF-23, İnflamasyon ve Demir Metabolizması

Yıl 2020, Cilt: 42 Sayı: 2, 195 - 202, 17.03.2020
https://doi.org/10.20515/otd.540614

Öz

Bu çalışmanın amacı erken evre
Otozomal Dominant Polikistik Böbrek Hastalığı’nda (ODPBH) serum Fibroblast
Growth Faktör-23 (sFGF-23) düzeyleri ile demir metabolizması, inflamasyon ve
karotis intima-media kalınlığı (KİMK) arasındaki ilişkiyi araştırmaktır. Çalışma
Bursa Yüksek İhtisas Eğitim ve Araştırma Hastanesinde gerçekleştirildi.
Çalışmaya 40 ODPBH hastası (24 kadın) ile 40 kişilik sağlıklı kontrol (21
kadın) grubu alındı. Serum FGF-23 düzeyleri ELİSA yöntemi ile çalışıldı. Tüm
çalışma popülasyonundan KİMK ölçümü yapıldı. Serum FGF-23 düzeyleri ile KİMK,
hs-CRP, nötrofil/lenfosit oranı (NLO) ve demir parametreleri arasındaki ilişki
korelasyon analizi ile değerlendirildi. Hasta grubunun sFGF-23 düzeyi
istatistiksel olarak anlamlı düzeyde daha yüksekti. Hasta grubunda 245(182-963)
pg/mL, kontrol grubunda 220(34-494) pg/mL, (P< 0.001).  NLO ve hs-CRP düzeyi hasta grubunda kontrol
grubuna göre istatistiksel olarak daha yüksekti (sırasıyla, P< 0.001, P=
0.003). Ayrıca KİMK hasta grubunda, kontrol grubuna göre anlamlı düzeyde daha
yüksek saptandı (P= 0.037). sFGF-23 düzeyleri ile kalsiyum, hemoglobin,
hematokrit, serum demir, ferritin ve NLO arasında anlamlı negatif korelasyon
(sırasıyla, P= 0.009, P= 0.035, P= 0.002, P= 0.033, P= 0.017, P= 0.023),  sFGF-23 ile fosfor ve total demir bağlama
kapasitesi arasında ise anlamlı pozitif korelasyon saptandı (P= 0.010, P=
0.049). sFGF-23 düzeyi ile PTH, hs-CRP ve KİMK arasında ise korelasyon
saptanmadı. Multivariate lineer regresyon analizinde serum fosfor düzeyi sFGF-23
tahmininde bağımsız değişken olarak saptandı. Erken evre ODPBH’da sFGF-23
düzeyi demir eksikliği ile ilişkiliyken inflamasyon ve ateroskleozis arasında
ilişki saptanmadı. 

Kaynakça

  • References:1. Isakova T, Wahl P, Vargas GS, et al. Fibroblast growth factor 23 is elevated before parathyroid hormone and phosphate in chronic kidney disease. Kidney international. 2011;79:1370–1378.
  • 2. Lukaszyk E, Lukaszyk M, Koc-Zorawska E, Bodzenta-Lukaszyk A, Malyszko J. Fibroblast growth factor 23, iron and inflammation are they related in early stages of chronic kidney disease? Arch Med Sci. 2017;13, 4: 845–850
  • 3. Masanobu Kawai. The FGF23/Klotho axis in the regulation of mineral and metabolic homeostasis. Horm Mol Biol Clin Invest. 2016;28(1): 55–67
  • 4. Scialla JJ, Xie H, Rahman M, et al.; Chronic Renal Insufficiency Cohort (CRIC) Study Investigators. Fibroblast growth factor-23 and cardiovascular events in CKD. J Am Soc Nephrol. 2014;25: 349-60.
  • 5. Mirza MA, Larsson A, Melhus H, Lind L, Larsson TE. Serum intact FGF23 associate with left ventricular mass, hypertrophy and geometry in an elderly population. Atherosclerosis. 2009;207: 546-51.
  • 6. Kocaman O, Oflaz H, Yekeler E, et al. Endothelial dysfunction and increased carotid intima-media thickness in patients with autosomal dominant polycystic kidney disease. Am J Kidney Dis, 2004;43: 854-60.
  • 7. Pavik I, Jaeger P, Kistler AD, et al. Patients with autosomal dominant polycystic kidney disease have elevated fibroblast growth factor 23 levels and a renal leak of phosphate. Kidney Int. 2011; 79: 234-40.
  • 8. Munoz Mendoza J, Isakova T, Ricardo AC, et al.; Chronic Renal Insufficiency Cohort. Fibroblast Growth Factor 23 and Inflammation in CKD. Clin J Am Soc Nephrol. 2012;Jul;7(7):1155-62.
  • 9. Menon V, Rudym D, Chandra P, Miskulin D, Perrone R, Sarnak M. Inflammation, oxidative stress, and insulin resistance in polycystic kidney disease. Clin J Am Soc Nephrol. 2011;6:7-13.
  • 10. Imel EA, Peacock M, Gray AK, Padgett LR, Hui SL, Econs MJ. Iron modifies plasma FGF23 differently in autosomal dominant hypophosphatemic rickets and healthy humans. J Clin Endocrinol Metab. 2011;96:3541–9.
  • 11. Braithwaite V, Prentice AM, Doherty C, Prentice A. FGF23 is correlated with iron status but not with inflammation and decreases after iron supplementation: a supplementation study. Int J Pediatr Endocrinol 2012;Oct 26 (1):27.
  • 12. Wolf M, White KE. Coupling fibroblast growth factor 23 production and cleavage: iron deficiency, rickets, and kidney disease. Curr Opin Nephrol Hypertens 2014;23: 411-9
  • 13. Spichtig D, Zhang H, Mohebbi N, et al. Renal expression of FGF23 and peripheral resistance to elevated FGF23 in rodent models of polycystic kidney disease. Kidney Int. 2014;85:1340-50
  • 14. Pavik I, Jaeger P, Ebner L, et al. Soluble klotho and autosomal dominant polycystic kidney disease. Clin J Am Soc Nephrol. 2012;7:248-57.
  • 15. Yildiz A, Gul CB, Ersoy A, et al. Arterial Dysfunction in Early Autosomal Dominant Polycystic Kidney Disease Independent of Fibroblast Growht Factor 23, Iranian Journal of Kidney Diseases. 2014;8; 443-9.
  • 16. Turkmen K, Tufan F, Selçuk E, Akpınar T, Oflaz H, Ecder T. Neutrophil-to-lymphocyte ratio, insulin resistance, and endothelial dysfunction in patients with autosomal dominant polycystic kidney disease. Indian J Nephrol. 2013;23:34-40.
  • 17. Abdallah E, Mosbah O, Khalifa G, Metwaly A, El-Bendary O. Assessment of the relationship between serum soluble Klotho and carotid intimaemedia thickness and left ventricular dysfunction in hemodialysis patients. Kidney Res Clin Pract 2016;35(1): 42-49
  • 18. David V, Martin A, Isakova T, et al. Inflammation and functional iron deficiency regulate fibroblast growth factor 23 production. Kidney Int. 2016;89(1):135–146.
  • 19. Holecki M, Chudek J, Owczarek A, et al. Inflammation but not obesity or insulin resistance is associated with increased plasma fibroblast growth factor 23 concentration in the elderly. Clin Endocrinol 2015;82(6):900–909
  • 20. Munoz Mendoza J, Isakova T, Ricardo AC, et al. Chronic Renal Insufficiency Cohort. Fibroblast growth factor 23 and Inflammation in CKD. Clin J Am Soc Nephrol 2012;7(7):1155–1162
  • 21. Hryszko T, Rydzewska-Rosolowska A, Brzosko S, Koc-Zorawska E, Mysliwiec M. Low molecular weight iron dextran increases fibroblast growth factor-23 concentration, together with parathyroid hormone decrease in hemodialyzed patients. Ther Apher Dial 2012;16(2):146–151
  • 22. Block GA, Fishbane S, Rodriguez M, et al. A 12-week, double-blind, placebo-controlled trial of ferric citrate for the treatment of iron deficiency anemia and reduction of serum phosphate in patients with CKD stages 3–5. Am J Kidney Dis 2015;65(5):728–736
  • 23. Prats M, Font R, Garcia C, Cabré C, Jariod M, Vea AM. Effect of ferric carboxymaltose on serum phosphate and C-terminal FGF23 levels in non-dialysis chronic kidney disease patients: post hoc analysis of a prospective study. BMC Nephrol 2013;14:167
  • 24. Imel EA, Liu Z, McQueen AK, et al. Serum fibroblast growth factor 23, serum iron and bone mineral density in premenopausal women. Bone 2016; 86:98–105
  • 25. Eser B, Yayar O, Buyukbakkal M, et al. The Fibroblast growth factor is associated to left ventricularmass index, anemia and low values of transferrin saturation. Nephrologia. 2015;35(5):465-72.
Toplam 25 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

İbrahim Doğan 0000-0001-8489-4985

Birol Ocak 0000-0001-7537-1699

Barış Eser Bu kişi benim 0000-0003-2025-2013

Hüseyin Kayadibi 0000-0002-3922-4517

Sultan Özkurt Bu kişi benim 0000-0001-7552-2186

Gürcan Kısakol 0000-0003-2983-4335

Yayımlanma Tarihi 17 Mart 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 42 Sayı: 2

Kaynak Göster

Vancouver Doğan İ, Ocak B, Eser B, Kayadibi H, Özkurt S, Kısakol G. FGF-23, Inflammation and Iron Metabolism in The Early Stages of Autosomal Dominant Polycystic Kidney Disease. Osmangazi Tıp Dergisi. 2020;42(2):195-202.


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