FGF23与糖尿病肾病的相关性研究进展

Research Progress on the Correlation between FGF23 and Diabetic Kidney Disease

摘要: 近年来随着全球糖尿病患病率的持续攀升，糖尿病肾病(Diabetic kidney disease, DKD)已成为慢性肾脏病(Chronic kidney disease, CKD)和终末期肾病的首要病因，严重威胁患者的生存质量和长期预后。DKD作为糖尿病患者最常见的慢性微血管并发症之一，是由长期高血糖所致的肾脏结构和功能进行性损害的疾病，其特征性临床表现为持续性高血压、难治性蛋白尿和进行性肾功能下降，常合并显著的钙磷代谢紊乱。成纤维细胞生长因子23 (Fibroblast growth factor 23, FGF23)是一种主要由骨细胞和成骨细胞分泌的内源性生长因子，通过与FGFR-α-Klotho受体复合物结合，调控肾脏磷酸盐排泄和活性维生素D代谢，维持血磷平衡；但在糖尿病中，其表达异常升高，驱动钙磷代谢紊乱和血管损伤。因此，深入阐明其分子机制并探索其作为疾病预测标志物的临床价值对于改善患者的预后至关重要。现就国内外有关血清FGF23水平与DKD相关性的研究进行综述。

Abstract: Diabetic kidney disease (DKD) has become the leading cause of chronic kidney disease (CKD) and end-stage renal disease with the continuous rise in the global prevalence of diabetes in recent years, posing a serious threat to patients’ quality of life and long-term prognosis. DKD, one of the most common chronic microvascular complications in diabetic patients, is a progressive disorder of renal structure and function caused by prolonged hyperglycemia. DKD is clinically characterized by persistent hypertension, refractory proteinuria, and progressive decline in renal function, which is frequently accompanied by serious abnormalities in calcium-phosphorus metabolism. Fibroblast growth factor 23 (FGF23), an endogenous growth factor mainly secreted by bone cells and osteoblasts, usually binds to the FGFR-α-Klotho receptor complex to regulate renal phosphate excretion and active vitamin D metabolism to maintain blood phosphorus balance; yet the expression of FGF23 is elevated abnormally, driving calcium-phosphorus metabolism disorders and vascular damage in diabetes. Therefore, a deeper understanding of its molecular mechanisms and exploration of its clinical value as a predictive biomarker are crucial for improving patient prognosis. This review summarizes current research on the correlation between serum FGF23 levels and DKD, both domestically and internationally.