title: Effect of serum FGF-23, MGP and fetuin-A on calcium-phosphate metabolism in maintenance hemodialysis patients.
abstract: This study was aimed to explore the role of serum fibroblast growth factor (FGF)-23, matrix Gla protein (MGP) and fetuin-A in the calcium-phosphate metabolism and their predicting value in coronary artery calcification in maintenance hemodialysis (MHD) patients. This study included 64 patients who receive hemodialysis in our hospital. The serum FGF-23, MGP and fetuin-A were analyzed by enzyme-linked immunosorbent assay (ELlSA). Coronary artery calcification score (CACS) was evaluated by coronary artery computed tomography scan. The 64 patients (30 males, 34 females, 60.6 ± 11.3 years of age) received an average dialysis vintage of 6.88 ± 2.94 years. We divided the CACS into three levels, and 13 (20.31%), 16 (25%), and 35 (54.69%) exhibited a CACS of 0-100, 100-400, and >400, respectively. Dialysis vintage, serum FGF-23, fetuin-A, phosphorus and high-density lipoprotein-C levels were identified as independent variables of CACS by stepwise multiple regression analysis. The area under receiver operating characteristic curve indicated that serum FGF-23 and fetuin-A were useful for identifying CAC in MHD patients. The cut-off value corresponding to the highest Youden's index was serum FGF-23 ≥ 256 pg/mL and fetuin-A ≤ 85 μg/mL, which was defined as the optimal predictors of CAC. Different combinations of serum FGF-23 and fetuin-A in parallel or in series effectively boosted the identification of CAC. The incidence of CAC is high in MHD patients. Serum FGF-23 and fetuin-A levels are closely correlated with CAC.
authors.affiliation: Division of Nephrology, the Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China; Division of Internal Medicine, Ningbo First Hospital, Medical School of Ningbo University, Ningbo, China.
authors.forename: Dong-Mei
authors.initials: DM
authors.lastname: Xiao
authors.forename: Qing
authors.initials: Q
authors.lastname: Wu
authors.forename: Wei-Feng
authors.initials: WF
authors.lastname: Fan
authors.forename: Xian-Wu
authors.initials: XW
authors.lastname: Ye
authors.forename: Jian-Ying
authors.initials: JY
authors.lastname: Niu
authors.forename: Yong
authors.initials: Y
authors.lastname: Gu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002118:Calcium / Q000097:blood / Q000378:metabolism*; D002135:Calcium-Binding Proteins / Q000097:blood*; D016326:Extracellular Matrix Proteins / Q000097:blood*; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010710:Phosphates / Q000097:blood / Q000378:metabolism*; D006435:Renal Dialysis / Q000379:methods*; D060749:alpha-2-HS-Glycoprotein / Q000378:metabolism*; D000097568:Matrix Gla Protein
chemical_list: D002118:Calcium; D002135:Calcium-Binding Proteins; D016326:Extracellular Matrix Proteins; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors; D010710:Phosphates; D060749:alpha-2-HS-Glycoprotein; D000097568:Matrix Gla Protein; C000717427:FGF23 protein, human
keywords: Fibroblast growth factor 23; calcium and phosphate metabolism; coronary artery calcification score; fetuin-A; maintenance hemodialysis; matrix Gla protein