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慢性肾脏病(CKD)患者心血管并发症发生率较普通人群增高,心血管疾病(CVD)是CKD进展的重要危险因子。CKD患者的矿物质与骨代谢异常(MBD)包括血清全段甲状旁腺激素(i PTH)升高、维生素D缺乏及高磷血症等,均为CVD的独立影响因素。成纤维细胞生长因子23(FGF23)能调节体内磷和维生素D代谢水平。血浆FGF23水平在CKD患者早期即进行性升高,一方面是机体对尿毒症状态的适应性变化,另一方面也是骨病与心血管并发症等病理过程的起始因素。血浆FGF23水平与CKD患者的左心室肥厚(LVH)、血管钙化、心血管功能异常及死亡率增加相关。现将FGF23的生理特点及其与CVD的关系、介导CVD的机制等作一综述。
The incidence of cardiovascular complications in patients with chronic kidney disease (CKD) is higher than in the general population. Cardiovascular disease (CVD) is an important risk factor for the progression of CKD. The mineral and bone metabolic abnormalities (MBD) in patients with CKD include elevated serum total parathyroid hormone (i PTH), vitamin D deficiency and hyperphosphatemia, all of which are independent predictors of CVD. Fibroblast growth factor 23 (FGF23) regulates the metabolism of phosphorus and vitamin D in the body. Plasma FGF23 levels in patients with CKD early progressive increase, on the one hand is the body’s adaptive changes in uremic status, on the other hand is also a bone disease and cardiovascular complications and other pathological processes of the starting factor. Plasma FGF23 levels are associated with left ventricular hypertrophy (LVH), vascular calcification, cardiovascular dysfunction and increased mortality in CKD patients. Now the physiological characteristics of FGF23 and its relationship with CVD, the mechanism of CVD-mediated were reviewed.