Research On The Correlation Of Between The Level Of Fibroblast Growth Factor23and Cardiovascular Disease In Continuous Ambulatory Peritoneal Dialysis Patients

Objects:To investigate the correlation of between the level of fibroblast growth factor23(FGF-23) and cardiovascular disease in continuous ambulatory peritoneal dialysis(CAPD) patients.Methods:Recruitment of58cases of CAPD patients and30cases healthy subjects ascontrol groups which were matched in ages, gender. The levels of serum creatinine, serumalbumin (ALB), triglycerides (TG), total cholesterol (TC), serum calcium (Ca2+) andphosphorus (P3-) are routine measured by the automatic chemistry analyzer. Theparathyroid hormone PTH is measured through the chemiluminescence immunoassaymethod. Moreover, the sensitivity C-reactive protein (CRP) is detected by immunescattering method while the FGF-23and1,25-(OH)2VitD3are detected by ELISA method.The color Doppler ultrasonography is applied using in detecting of carotid arteryatherosclerotic plaque in CAPD patients and provide the value of carotid intima-mediathickness (IMT). In additional, the values of cardiac diastolic left ventricular diameter(LVDd), end-diastolic interventricular septum thickness (IVST), left ventricular posteriorwall thickness (LVPWT) and ejection fraction (LVEF) are measured by echocardiographyand calculated according to Devereux left ventricular mass index (LVMI). Comparison ofthe level of FGF-23and its clinically relevant parameters was conducted between CAPDpatients and healthy subjects. However, the CAPD patients were divided into combinedcardiovascular disease group and non-combined cardiovascular disease group. Wecompared the level of FGF-23and its clinically relevant parameters in order to finding thecorrelation of between the level of FGF-23and cardiovascular disease and analyzingclinical significance. Results:1. The serum level of fibroblast growth factor23is significantly increased in CAPDpatients than in the healthy controls (343.8±123.1ng/L vs26.8±11.3ng/L,P<0.01).2. There are significant difference in ages, BMI, FGF23, hemoglobin, hsCRP, SBP,DBP, LVDd, LVPWT, IVST and LVEF aspects between the CAPD combinedcardiovascular disease groups and non-combined cardiovascular disease groups. Moreover,the different groups show no significant difference in serum calcium, phosphorus,1,25-(OH)2VitD3, iPTH, Scr, EGFR, blood glucose, triglycerides, cholesterol, ALB, IMTaspects. In additional, the level of serum FGF-23in the combined cardiovascular diseasegroups is apparently higher than in the non-combined groups (485.4±129.6ng/Lvs202.4±138.6ng/L,P＜0.01).3. The level of serum FGF-23in the carotid atherosclerosis group is apparently higherthan in the control group (453.4±134.6ng/Lvs234.2±148.8ng/L, P＜0.01).4. The level of serum FGF-23is negatively correlated with the level of EGFR and1,25-(OH)2VitD3(r values are-0.519and-0.479respectively,P均<0.01) while is positivelycorrelated with the serum phosphorus, iPTH and Scr in CAPD patients (r values are0.389,0.689and0.419respectively(all P>0.05).5. The IMT value is negatively correlated with the level of FGF-23, TC, ages andhsCRP(βvalues are0.432，0.298，0.243，0.193，all P＜0.01) while is no relationship withthe level of BMI, Ca2+, P3-,1,25-(OH)2VitD3, iPTH, Scr, eGFR, TG, ALB, Hb, SBP andDBP in CAPD patients(all P>0.05).6. The LVMI value is positively correlated with the level of FGF-23, SBP andDBP(βvalues are0.348，0.489，0.329，all P＜0.01) while is no relationship with ages, BMI,Ca2+, P3-,1,25-(OH)2VitD3, iPTH, Scr, eGFR, TC, TG, ALB, Hb and hsCRP in CAPDpatients(all P>0.05).Conclusions1. The level of serum FGF-23is apparently elevated in CAPD patients which could beaffected by the level of EGFR, P3-,1,25-(OH)2VitD3,iPTH and Scr.2. The level of serum FGF-23is associated with the carotid atherosclerosis or LVHthat could be play an important role in the development of carotid atherosclerosis and LVH.From that, we predicted that whether FGF-23is the independent risk factor during thedevelopment of carotid atherosclerosis or LVH. 3. The level of serum FGF-23is associated with cardiovascular disease in CAPDpatients,so FGF-23could be a sensitive marker during the development of cardiovasculardisease in the CAPD patients.