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

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.

Anahtar Kelimeler

• Autosomal dominant polycystic kidney disease,Fibroblast growth factor-23,Inflammation

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

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. 

Anahtar Kelimeler

• Demir Metabolizması,FGF-23,İnflamasyon

Kaynakça

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