Correlation Study Between Plasma FGF23 And Left Ventricular Hypertrophy In Patients With Chronic Kidney Disease

Objective:To discuss the correlation of plasma fibroblast growth factor23(FGF23)and left ventricular hypertrophy(LVH)in patients with chronic kidney disease(CKD).Methods:From october 2016 to october 2017,64 cases patients with CKD stage 1 to 5 were selected in the department of renal medicine which was affiliated hospital of north sichuan medical college.There were 16 cases in group A of CKD stage 1 and 2,16 cases in group B of CKD stage 3,16cases in group C of CKD stage 4,16 cases in group D of CKD stage 5.In the control group,32 normal healthy persons in our hospital were selected in the same period.The level of plasma FGF23 was examined by enzyme linked immunosorbent assay with double antibody sandwich method.Left ventricular end-diastolic diameter(LVDd),left ventricular posterior wall thivkness(LVDs),left ventricular end-systolic diameter(LVPWT)and interventricular septal thickness(IVST)were measured by echocardiography.The left ventricular mass index(LVMI)was calculated by Devereux formula,LVH is determined by LVMI(LVMI of the male?125g/1.73m~2,the female?120g/1.73m~2).The relationship between LVMI and plasma FGF23 and clinical data was analyzed by correlation analysis.All the data were analyzed by SPSS20.0 software.The measured data were expressed as mean±standard deviation(?X±S).The experimental group and the control group were compared by t test of independent sample.Single factor analysis of variance for multigroup mean comparison.correlation analysis was tested by Pearson,whether the independent risk factors were determined by multiple stepwise linear regression,P<0.05 showed that the difference was statistically significant.Results:1.Plasma FGF23(6.74±6.16 ng/ml)in patients with CKD was significantly higher than that in the healthy control group(1.22±0.19ng/ml),the difference was statistically significant(P<0.05),and the level of plasma FGF23 gradually increased with the development of CKD.2.In patients with CKD,the incidence of LVH was 39.06%.3.Pearson correlation analysis showed that the level of plasma FGF23was positively correlated with LVMI(r=0.372,P=0.002).4.Multiple stepwise linear regression showed that plasma FGF23 was an independent risk factor for LVMI(B=0.272,t=2.272,P=0.027).The difference was statistically significant(P<0.05).5.Pearson correlation analysis showed that there was a positive correlation between plasma FGF23 and serum phosphorus(r=0.258,P=0.040),and parathyroid hormone(r=0.321,P=0.010).There was no significant correlation with the serum calcium(r=-0.028,P=0.829).6.Multiple stepwise linear regression analysis showed that serum phosphorus(B=0.137,t=1.002,P=0.020)and parathyroid hormone(B=0.321,t=2.668,P=0.010)were independent risk factors for FGF23.The difference was statistically significant(P<0.05).Conclusion:1.The incidence of LVH in patients with CKD is high.The rate is 39.06%in this study.2.The level of plasma FGF23 in CKD was significantly increased,which is a positive correlation with serum creatinine and can reflect the degree of renal damage in some extent.3.Plasma FGF23 is positively correlated with LVH and is an independent risk factor for LVH,which is expected to be a therapeutic target for cardiovascular disease and improve the survival rate of in patients with CKD.4.Serum phosphorus and parathyroid hormone can affect plasma FGF23expression and are independent risk factors of plasma FGF23.