Clinical Study On The Correlation Between FGF-23, α-Klotho Protein And TCM Syndromes Of Diabetic Nephropathy And Disease Progressio

Diabetic kidney disease(DKD)is one of the most common and serious microvascular complications caused by diabetes.The onset of diabetic kidney disease is hidden,there is no exact and effective method for its treatment,and the traditional laboratory examination indexes are not sensitive to the prediction of the disease progress.Previous studies have found that FGF23 and α-Klotho proteins have a clear correlation with the progression of CKD(Chronic Kidney Disease),so it may be a biomarker for the evaluation and prediction of DKD.The theory of "The Mass of the Kidney-collaterals" is a theory that guides the clinical diagnosis and treatment of kidney diseases in modern Chinese medicine.The theory of "Ju-San-XiaoZhang" is based on the theory of "The Mass of the Kidney-collaterals",which describes the pathological changes of "The Mass of the Kidney-collaterals" dynamically.Based on the theories of "The Mass of the Kidney-collaterals" and "Ju-San-Xiao-Zhang",patients with diabetic kidney disease were divided into three groups:early stage,middle stage and late stage.Objective:to explore the relationship between serum FGF-23 and α-Klotho protein in the course of DKD and the progress of the disease and the syndrome of traditional Chinese medicine.It provides a theoretical basis for the theory of "The Mass of the Kidney-collaterals" and a basis for the further study of the mechanism of TCM’s prevention and treatment of DKD guided by this theory.Methods:The clinical data of 127 diabetic nephropathy patients were collected,serum-Klotho protein was detected by Elisa and FGF-23 was detected by Luminex antibody chip.SPSS20 statistical software was used to analyze the clinical data and serum FGF-23,-Klotho Protein.Results:1.The occurrence rate of Yin Deficiency,Qi deficiency and Yang deficiency in Zheng Deficiency Syndrome was higher,and the order of Yang Deficiency Syndrome in late group was higher than that in the former two groups.The proportion of pathogenic factors in pathogenic heat syndrome is high,such as Internal heat syndrome and Damp heat Syndrome.Yin Deficiency and Internal heat were the most common syndromes in the early,middle and late stage groups.2.α-Klotho protein level decreased in the early,middle and late groups in turn(p=0.107).α-Klotho protein was significantly different between the early and late groups(p=0.035).FGF-23 increased in turn in the early,middle and late groups(P=0.000).Fgf-23 had statistical differences between the early and late groups(p=0.00),and between the middle and late groups(p=0.00).3.There was a linear correlation between eGFR and α-Klotho Protein(p=0.008)with a coefficient of 0.237.Fgf-23 had a linear correlation with eGFR and 24-hour urinary protein,the coefficients were-0.605 and 0.552 respectively.4.Klotho protein level in Internal heat syndrome group was higher than that in non-Internal Heat syndrome group(P=0.012).The level of FGF-23 in Blood Stasis Syndrome group was higher than that in nonBlood Stasis Syndrome Group(P=0.031).Conclusion:1.Fgf-23 and α-Klotho protein decreased gradually with the progression of DKD.Serum FGF-23 and α-Klotho protein can be used to evaluate the progression of Diabetic kidney disease and may become a new therapeutic evaluation index.2.FGF-23 may be one of the bases of the theory of "The Mass of the Kidney-collaterals",and it may be the target of Chinese medicine to prevent and treat DKD guided by this theory.