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

Year 2020, Volume: 42 Issue: 2, 195 - 202, 17.03.2020

İbrahim Doğan , Birol Ocak , Barış Eser Hüseyin Kayadibi , Sultan Özkurt Gürcan Kısakol

https://doi.org/10.20515/otd.540614

Abstract

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.

Keywords

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

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

Abstract

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. 

Keywords

Demir Metabolizması, FGF-23, İnflamasyon

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