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儿童的FGF23轨迹和与慢性病进展的关联:儿童慢性病研究
Farzana Perwad1, Matthew B Matheson2, Eva Glenn Lecea1
1University of California San Francisco.
Clinical journal of the American Society of Nephrology : CJASN
|February 5, 2026
概括
在患有慢性病 (CKD) 的儿童中,纤维细胞生长因子23 (FGF23) 水平在大多数患者中保持稳定. 然而,快速上升的FGF23度显著增加了功能衰竭的风险.
科学领域:
- 儿科脏病学 儿科脏病学
- 内分泌学 在内分泌学.
- 在病中的生物标志物
背景情况:
- 血纤维细胞生长因子23 (FGF23) 在慢性病 (CKD) 中增加,并预测不良结果.
- 在儿科渐进性CKD中,FGF23的纵向变化没有很好的特征.
研究的目的:
- 描述患有CKD的儿童FGF23度的纵向变化.
- 确定不同的FGF23轨迹及其与CKD进展和功能衰竭风险的关联.
主要方法:
- 在543名患有CKD 2-4期的儿童中,每两年测量C端FGF23和估计的淋巴膜过率 (eGFR).
- 使用线性混合模型和基于潜伏组的轨迹建模来分析FGF23,eGFR和变化.
- 考克斯的比例危险模型根据FGF23轨迹评估了功能衰竭的风险.
主要成果:
- FGF23每年增加3.7%,而eGFR在4年的中位数中每年减少3.8%.
- 确定了FGF23的三个轨迹:稳定 (64%),缓慢上升 (30%) 和快速上升 (6%).
- 快速上升的FGF23轨迹与较低的eGFR,较高的,蛋白尿和贫血有关,并且显著增加功能衰竭风险 (快速上升组为8倍).
结论:
- 大多数患有CKD的儿童保持稳定的FGF23水平.
- 加入快速增长的FGF23轨迹组与更高的进展到功能衰竭的风险有关.
- 需要进一步的研究来确定FGF23是否是儿童CKD进展的原因或后果.
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