Changes and significance of serum intact fibroblast growth factor-23, -klotho, monocyte chemotactic protein -1 and interleukin -18 in patients with diabetic nephropathy

Abstract

Objective To investigate the serum intact fibroblast growth factor (iFGF-23), -klotho protein, monocyte chemotactic protein 1 (MCP-1), interleukin (IL) -18 level in patients with diabetic nephropathy (DN) and their clinical significance. Methods All of 162 DN patients in our hospital from August 2014 to October 2016 were collected and divided into 3 subgroups according to urinary albumin ejection rate(UAER): A subgroup(52 cases) with UAER 20 g/min.At the same time, 80 healthy volunteers were collected as the control group.The serum levels of iFGF-23, MCP-1, and IL-18 were determined by enzyme-linked immunosorbent assay (ELISA), the -klotho protein in the plasma was detected by colloidal gold method.The urine microalbumin, serum creatinine (Scr), and blood urea nitrogen (BUN) in the plasma were detected by an automatic biochemical analyzer.The estimated glomerular filtration rate (EGFR) was calculated using the Chinese modified kidney meal test (MDRD). Results Compared with healthy controls, The serum iFGF-23, MCP-1 and IL-18 levels were significantly higher in DN patients than those of healthy controls(P<0.05). The serum -klotho protein was significantly lower in the DN patients than that in the healthy controls(P<0.05). The -klotho protein gradually decreased in A, B and C subgroups (P<0.05). The serum iFGF-23, MCP-1, and IL-18 in the B subgroup were higher than those in the A and C subgroups (P<0.05). Conclusion The level of serum iFGF-23, MCP-1 and IL-18 were significantly higher in DN patients, while the -klotho protein was significantly lower in DN patients.The changes of iFGF-23, MCP-1, IL-18 and -klotho were related with UAER of DN patients. Key words: Intact fibroblast growth factor; -klotho protein; Monocyte chemotactic protein 1; Interleukin -18; Diabetic nephropathy