成纤维细胞生长因子23在慢性肾脏疾病血磷代谢中的作用

 成纤维细胞生长因子23(FGF23)是近年来发现的由骨细胞产生的一种激素,主要作用是抑制肾小管磷重吸收和1,25(OH)₂D循环水平。慢性肾脏疾病(CKD)是世界范围内影响数百万人的公共卫生疾病。FGF23循环水平升高导致的血磷稳态失调是CKD早期和普遍的并发症。本文综述FGF23家族结构、FGF23在调节磷和维生素D代谢中的作用及其合成和分泌的调控。重点介绍FGF23在CKD中与血钙、血磷及甲状旁腺激素(PTH)的作用机制,以及FGF23在评估CKD进展、预测预后中的作用。分析表明,FGF23可能成为慢性肾脏疾病骨和矿物质代谢中的重要诊断标志和治疗对象。

Role of Fibroblast Growth Factor 23 in Physiological Regulation and Disorders of Phosphate Metabolism in Chronic Kidney Disease

The Fibroblast Growth Factor 23 (FGF23) is a recently discovered hormone, predominately produced by osteoblasts/osteocytes, whose major functions are to inhibit the renal tubular phosphate reabsorption and to suppress the circulating 1,25(OH)2D level. The chronic kidney disease (CKD) is a public health epidemic that would affect millions of people worldwide. The disordered phosphate homeostasis with elevated circulating levels of FGF23 is an early and pervasive complication of CKD. In this paper, we review the FGF superfamily, the mechanism of FGF23 in the phosphate and vitamin D metabolisms, and the relationship between FGF23 and PTH in CKD. In addition, we discuss the role of FGF23 in assessing the progression and the prognosis in CKD. The assessment of FGF23 may become an important diagnostic marker as well as a therapeutic target for the management of disordered bone and mineral metabolisms in CKD.