| Objective: The correlation with chronic kidney disease complicated with left ventricular hypertrophy and its TCM syndrome types change was used to be the breakthrough point.The relevence was discussed about the correlation of patients with different stages of CKD serum Fibroblast growth factor-23(FGF23)levels and left ventricular hypertrophy and the TCM syndrome types,in order to further clarify whether FGF23 serum can be used as chronic kidney disease(CKD)with left ventricular hypertrophy of biomarkers,and FGF23 May become CKD objective indicator of TCM syndrome types.Methods: 1.86 patients with CKD diagnostic criteria and complete clinical data CKD3 ~ 5 patients were selected from February 1,2017 to June 1,2017 in Ruikang Hospital of Guangxi University of TCM affiliated nephrology hospital as the observation group.32 cases of healthy physical examination in the same period were as the control group.The observation group was then grouped as follows:(1)CKD Stage:CKD3 stage group,CKD4 stage group,CKD5 stage group;(2)yes or not left ventricular hypertrophy: left ventricular hypertrophy(LVH)group and non-left ventricular hypertrophy(NLVH)group;(3)according to TCM syndrome grouping: spleen kidney qi deficiency syndrome group,spleen kidney Yang deficiency syndrome group,qi Yin deficiency syndrome group,liver and kidney Yin deficiency syndrome group,Yin and Yang deficiency syndrome group.2.The blood and urine samples were collected from the observation group and the healthy control group after 12 hours of fasting before examination.The serum creatinine,blood urea nitrogen,urine protein,blood phosphorus,blood calcium and other laboratory indexes were detected,and the clinical data of gender,age,weight,basic diseases and heart color ultrasound were collected.3.Serum FGF23 level was detected by enzyme-linked immunosorbent assay.Results: 1.There were 45 men(52.3%)and 41 female(47.7%)in the observation group,mean age was(57.2±16.7)years old and average weight was(60±2.2)kg;control group had 18 cases male(56.2%),14 cases female(43.8%),mean age was(52.5±12.6)years old,average weight was(64.3±3.9)kg,the two groups in gender,age,weight gain was no statistically significant differences(P > 0.05).2.After t test,the serum FGF23 level(183.4±62.3)ng/ml in CKD group was significantly increased in the healthy control group(64 ±37.6)ng/ml,and the difference was statistically significant(P<0.05).FGF23 level of CKD3~5 phase was analyzed further with single factor variance,CKD3(171.5±52.2)ng/ml,CKD4(184.8±47.3)ng/ml,CKD5(192.4± 63.6)ng/ml,comparison of serum FGF23 levels between the three groups,>CKD4 stage of CKD5 stage and >CKD3 period,all of the differences were statistically significant(P<0.05).3.After two yuan Logistic regression analysis,the results showed that serum FGF23,serum creatinine and urine protein were related factors of CKD complicated with left ventricular hypertrophy(B correlation coefficient absolute value was greater than 0.2,P < 0.05).4.Spearman correlation analysis showed that serum FGF23 level was positively correlated with urinary protein creatinine and urea nitrogen,and was negatively correlated with albumin blood calcium.5.The ROC curve was made about serum FGF23,serum creatinine and urine protein,the area under the curve in the order: 0.843 0.757 0.720 thus,the area of the ROC curve of serum FGF23 is the largest and statistically significant(P = 0.002),the sensitivity was 91.4%,specificity was 79.8%.6.The level of serum FGF23 in each group was compared,the difference between spleen and kidney qi deficiency syndrome group was(169.2±47.5)ng/ml and liver kidney yin deficiency group(186.6±36.5)ng/ml,compared with the rest groups,the difference was statistically significant(P<0.01).Conclusion : 1.The level of serum FGF23 is significantly elevated in the CKD3~5 phase and participates in the metabolism of calcium and phosphorus in CKD patients,which may be a sensitive indicator of the progress of CKD.2.The serum FGF23 increased significantly in CKD patients with left ventricular hypertrophy,suggesting that FGF23 may be a biomarker for CKD associated left ventricular hypertrophy.3.The serum FGF23 may become an objective index of spleen and kidney qi deficiency syndrome and liver kidney yin deficiency syndromeof CKD patients.It provides some clinical data for the treatment of CKD disease in traditional Chinese medicine. |
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