中国血液净化

中国血液净化 ›› 2025, Vol. 24 ›› Issue (08): 653-658.doi: 10.3969/j.issn.1671-4091.2025.08.007

• 临床研究 • 上一篇    下一篇

血清成纤维细胞生长因子21与腹膜透析患者不同部位血管钙化的相关性研究

张圆圆    刘天驰    陈香吟    曹婧媛    杨 艳    卢国元    赵诗竹   

  1. 215000 苏州，1苏州大学附属第一医院肾内科
    210000 南京，2东南大学医学院
    213000 常州，3常州市第一人民医院肾内科
    225300 泰州，4泰州市人民医院肾内科
  • 收稿日期:2024-08-19 修回日期:2025-05-12 出版日期:2025-08-12 发布日期:2025-08-12
  • 通讯作者: 赵诗竹 E-mail:15850051842@163.com
  • 基金资助:

Correlation between serum fibroblast growth factor 21 and vascular calcification in different parts of peritoneal dialysis patients

ZHANG Yuan-yuan, LIU Tian-chi, CHEN Xiang-yin, CAO Jing-yuan, YANG Yan, LU Guo-yuan, ZHAO Shi-zhu   

  1. Department of Nephrology, The First Affiliated Hospital of Soochow University, Suzhou 215000, China; 2School of Medicine, Southeast University, Nanjing 210000, China; 3Department of Nephrology, The First People’s Hospital of Changzhou, Changzhou 213000, China; 4Department of Nephrology, Taizhou People’s Hospital, Taizhou 225300, China
  • Received:2024-08-19 Revised:2025-05-12 Online:2025-08-12 Published:2025-08-12
  • Contact: 213000 常州，3常州市第一人民医院肾内科 E-mail:15850051842@163.com

摘要： 目的 血管钙化与腹膜透析(peritoneal dialysis，PD)患者心血管疾病发生密切相关。成纤维细胞生长因子21(fibroblast growth factor 21，FGF21)作为一种内分泌激素对心血管具有保护作用。本研究探究了PD患者血清FGF21与不同部位血管钙化的相关性。 方法 纳入2021年8月─2022年10月于苏州大学附属第一医院肾内科行腹膜透析充分性评估的PD患者，将其作为PD组，纳入同期于苏州大学附属第一医院体检的健康人群作为对照组。测定血清FGF21、FGF23水平。使用GE工作站处理PD组患者的胸腹部平扫CT，定量评估冠状动脉钙化(coronary artery calcification，CAC)及腹主动脉钙化(abdominal artery calcification，AAC)的体积。按照钙化发生与否进行分组，使用多因素Logistic回归分析FGF21与CAC及AAC的发生是否具有相关性。 结果 共纳入PD组患者136例，对照组20例，PD组患者血清FGF21高于对照组(Z=5.087，P＜0.001)。随着年龄的增长(r=0.247，P=0.004)、透析龄的延长(r=0.306，P＜0.001)，PD组患者血清FGF21逐渐升高，血清FGF21水平与CAC体积(r=0.254，P=0.005)及AAC体积(r=0.354，P＜0.001)呈正相关。不同部位血管钙化危险因素不同，FGF21升高与PD组患者AAC发生风险增加独立相关(OR=1.783，95% CI：1.251～2.541，P=0.001)，而与CAC发生与否无关联。 结论 PD组患者血清FGF21较正常人显著升高，且FGF21增加与AAC发生风险增加有关。未来，FGF21可能作为血管钙化的生物标志物及潜在治疗靶点。

关键词: 腹膜透析, 血管钙化, 成纤维细胞生长因子21

Abstract: Objective  Vascular calcification is closely related to cardiovascular disease in patients with peritoneal dialysis (PD). Fibroblast growth factor 21 (FGF21) as an endocrine hormone has a protective effect on cardiovascular function. This study explored the correlation between serum FGF21 and vascular calcification in different parts of vessels in PD patients.  Methods  PD patients who were evaluated for adequacy of PD in the Department of Nephrology, The First Affiliated Hospital of Soochow University from August 2021 to October 2022 were included in this study. Healthy people who underwent physical examination during the same period were recruited as the controls. Fasting blood serum was collected from all subjects, and serum FGF21 and FGF23 levels were determined by enzyme-linked immunoassay. Chest and abdomen CT were conducted in PD patients and processed by the GE workstation. Volume of coronary artery calcification (CAC) and abdominal aortic calcification (AAC) was quantitatively assessed. PD patients were grouped according to the presence of CAC or AAC. Multivariate logistic regression was used to analyze the relationship between serum FGF21 level and the presence of CAC or AAC.  Results  A total of 136 PD patients and 20 healthy controls were included in this study. Serum FGF21 in PD patients was significantly higher than that in normal subjects [383.0 (110.3～767.9) vs. 13.3 (5.5～129.1) pg/mL, Z=5.087, P＜0.001]. With the increase of age (r=0.247, P=0.004) and dialysis vintage (r=0.306, P＜0.001), serum FGF21 in PD patients was gradually increased. FGF21 was positively correlated with CAC volume (r=0.254, P=0.005) and AAC volume (r=0.354, P＜0.001). Furthermore, there were different risk factors for CAC and AAC. The increase of FGF21 was independently associated with the increased risk of AAC (OR=1.783, 95% CI: 1.251～2.541, P=0.001) rather than CAC in PD patients.  Conclusions  Serum FGF21 in PD patients is significantly higher than that in healthy people. The increase of FGF21 is associated with an increased risk of AAC. Therefore, FGF21 may serve as a biomarker and potential therapeutic target for vascular calcification.

Key words:  Peritoneal dialysis, Vascular calcification, Fibroblast growth factor 21

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