Associations of fibroblast growth factor 23 with urate metabolism in patients with chronic kidney disease

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• 作者：Teppei Sakoh^a ; ^b ; ^{tsakoh42@kyumed.jp" class="auth_mail" title="E-mail the corresponding author} ; Masaru Nakayama^a ; ^{mnaka@kyumed.jp" class="auth_mail" title="E-mail the corresponding author} ; Takuya Tsuchihashi^c ; ^{tuti@ns.yawata-mhp.or.jp" class="auth_mail" title="E-mail the corresponding author} ; Ryota Yoshitomi^a ; ^b ; ^{ryoshitomi.1130@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Shigeru Tanaka^b ; ^d ; ^{sigella1975@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Eisuke Katafuchi^a ; ^{kesuiechifutaka@kyumed.jp" class="auth_mail" title="E-mail the corresponding author} ; Akiko Fukui^a ; ^{akiko-march1119@hotmail.co.jp" class="auth_mail" title="E-mail the corresponding author} ; Yui Shikuwa^a ; ^{shiku.yui@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Naohiko Anzai^e ; ^{anzai@chiba-u.jp" class="auth_mail" title="E-mail the corresponding author} ; Takanari Kitazono^b ; ^{kitazono@intmed2.med.kyushu-u.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Kazuhiko Tsuruya^b ; ^f ; ^{tsuruya@intmed2.med.kyushu-u.ac.jp" class="auth_mail" title="E-mail the corresponding author}
• 关键词：CKD ; chronic kidney disease ; eGFR ; estimated glomerular filtration rate ; FGF ; fibroblast growth factor ; 1 ; 25(OH)2D ; 1 ; 25-dihydroxyvitamin D ; PTH ; parathyroid hormone ; SUA ; serum uric acid ; CUA ; uric acid clearance ; UEUA ; urinary excretion of uric acid ; FEUA ; fractional excretion of uric acid ; FEPi ; fractional excretion of phosphate ; FENa ; fractional excretion of sodium ; URAT ; urate transporter ; NHERF ; sodium-hydrogen exchanger regulatory factor ; Npt ; sodium-phosphate cotransporters ; ABCG ; ATP-bi
• 刊名：Metabolism
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：65
• 期：10
• 页码：1498-1507
• 全文大小：375 K

文摘

In patients with preserved kidney function, a positive association of fibroblast growth factor 23 (FGF23) with serum uric acid (SUA) has been reported; however, the relationship in overall chronic kidney disease (CKD) patients has not been investigated. No report has examined the relationship between FGF23 and uric acid clearance (CUA). The aim of the present study was to determine whether FGF23 is independently associated with urate metabolism in patients with CKD stages 1–5.

Materials and methods

In this cross-sectional study, 537 CKD patients were enrolled. SUA, CUA, FGF23, parathyroid hormone (PTH), and 1,25-dihydroxyvitamin D (1,25(OH)₂D) were measured. Multivariable linear regression analysis was applied to determine independent factors associated with SUA or CUA.

Results

In all patients, both SUA and CUA were independently associated with male sex, use of diuretics, use of uric acid-lowering agents, estimated glomerular filtration rate, and log FGF23 (β = 0.29, P < 0.01 for SUA; β = − 0.11, P < 0.01 for CUA), but not with log PTH or log 1,25(OH)₂D. Dyslipidemia and diabetes were also independent factors for SUA and CUA, respectively. In multivariable analyses by sex, log FGF23 was associated with SUA in both sexes (β = 0.32, P < 0.01 in males vs. β = 0.20, P = 0.02 in females). Conversely, log FGF23 was independently associated with CUA in males (β = − 0.15, P < 0.01), but not in females (β = − 0.09, P = 0.17).

Conclusions

FGF23 was independently associated with urate metabolism in this population of CKD patients. FGF23 might also have a stronger association with urate metabolism in males compared with females.