|Table of Contents|

Predictive value of serum FGF23-Klotho axis in patients with multiple myeloma complicated with kidney injury

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2024 17
Page:
3291-3296
Research Field:
Publishing date:

Info

Title:
Predictive value of serum FGF23-Klotho axis in patients with multiple myeloma complicated with kidney injury
Author(s):
QIN Na1; FENG Ruiting2; WANG Xuan1; GUAN Lina1; GUO Shuxia1
1.Department of Hematology,the Fifth Clinical Medical College of Henan University of Traditional Chinese Medicine(Zhengzhou People's Hospital),Henan Zhengzhou 450003,China;2.Center for Translational Medicine,the Fifth Clinical Medical College of Henan University of Traditional Chinese Medicine(Zhengzhou People's Hospital),Henan Zhengzhou 450003,China.
Keywords:
FGF23-Klotho axis; multiple myeloma; kidney injury; forecast
PACS:
R733.3
DOI:
10.3969/j.issn.1672-4992.2024.17.021
Abstract:
Objective:To investigate the predictive value of serum FGF23-Klotho axis in patients with multiple myeloma complicated with kidney injury.Methods:104 MM patients in our hospital were selected as the MM group,and were divided into kidney injury group(n=34) and non-kidney injury group(n=70) according to whether the patients had kidney injury.In the same period,80 healthy subjects in our hospital were selected as the control group.The expression of serum cystatin C(Cys-C),serum creatinine(Scr),β2 microglobulin(β2-mg),and serum FGF23 and Klotho were detected.ROC curve was used to analyze the predictive value of serum FGF23 and Klotho on MM combined with kidney injury.The correlation between serum FGF23,Klotho and Cys-C,Scr and β2-MG in renal injury group was analyzed.Results:The serum levels of Cys-C,Scr,β2-MG and FGF23 in MM group were significantly higher than those in control group,the serum Klotho level in MM group was significantly lower than that in control group(P＜0.05),and the FGF23/Klotho ratio in MM group was significantly higher than that in control group(P＜0.05).In MM patients,the serum levels of Cys-C,Scr,B2-MG and FGF23 in kidney injury group were significantly higher than those in non-kidney injury group(P<0.05),while the serum Klotho level in kidney injury group was significantly lower than that in non-kidney injury group(P<0.05).Logistic regression was used to analyze the effects of serum FGF23 and Klotho on kidney injury in MM patients.Binary Logistic regression was used to analyze the effects of serum FGF23 and Klotho on kidney injury in MM patients,and the results showed that serum FGF23 and Klotho were both entered into the regression model(P<0.05),which was an important factor affecting kidney injury in MM patients.ROC curve was used to analyze the predictive value of serum FGF23,Klotho and FGF23/Klotho ratio on MM combined kidney injury,and the areas under the curve were 0.839,0.831 and 0.962,respectively.Correlation analysis results showed that serum FGF23,FGF23/Klotho ratio was significantly positively correlated with Cys-C,Scr and β2-MG in renal injury group(P＜0.05),and serum Klotho was significantly negatively correlated with Cys-C,Scr and β2-MG in renal injury group(P＜0.05).Conclusion:Serum FGF23-Klotho axis has important regulatory value in multiple myeloma complicated with kidney injury,which is closely related to the renal function of patients,and has important predictive value in the occurrence of kidney injury in multiple myeloma patients,which is worthy of further clinical research.

References:

[1] HANAMURA I.Multiple myeloma with high-risk cytogenetics and its treatment approach［J］.Int J Hematol,2022,115(6):762-777.
[2] 李其辉,刘彦,王晶,等.新药时代早期复发对新诊断多发性骨髓瘤患者预后的影响及其危险因素分析［J］.中国实验血液学杂志,2023,31(1):148-153. LI QH,LIU Y,WANG J,et al.Analysis of the prognostic value and risk factors of early relapse for newly diagnosed multiple myeloma patients in the era of novel agents［J］.Chinese Journal of Experimental Hematology,2023,31(1):148-153.
[3] BRIDOUX F,LEUNG N,BELMOUAZ M,et al.Management of acute kidney injury in symptomatic multiple myeloma［J］.Kidney Int,2021,99(3):570-580.
[4] 厉吉霞,郭楠,于传亭,等.血NLR、β 2-MG和Cys-C对初诊多发性骨髓瘤患者合并肾损伤的预测价值［J］.国际免疫学杂志,2023,46(1):38-44. LI JX,GUO N,YU CT,et al.The value of serum NLR,β 2-MG and Cys-C in predicting renal impairment in initially diagnosed multiple myeloma patients［J］.International Journal of Immunology,2023,46(1):38-44.
[5]廖甄楠,李强,宋卓恒,等.FGF23/Klotho在急性肾损伤中的研究进展［J］.国际医药卫生导报,2022,28(10):1367-1371. LIAO ZN,LI Q,SONG ZH,et al.FGF23 and Klotho in AKI update［J］.International Medical and Health Review,2022,28(10):1367-1371.
[6]RAJKUMAR SV,DIMOPOULOS MA,PALUMBO A,et al.International myeloma working group updated criteria for the diagnosis of multiple myeloma［J］.Lancet Oncol,2014,15(12)：e538-548.
[7] HAGEN P,ZHANG J,BARTON K.High-risk disease in newly diagnosed multiple myeloma：beyond the R-ISS and IMWG definitions［J］.Blood Cancer J,2022,12(5):83.
[8] ALLEGRA A,DI GIOACCHINO M,TONACCI A,et al.Multiple myeloma cell-derived exosomes：Implications on tumorigenesis,diagnosis,prognosis and therapeutic strategies［J］.Cells,2021,10(11):2865.
[9] BERBARI HE,KUMAR SK.Initial therapeutic approaches to patients with multiple myeloma［J］.Adv Ther,2021,38(7):3694-3711.
[10] 俞玲.多发性骨髓瘤患者肾损伤预测模型的构建［J］.广东医学,2021,42(7):802-805. YU L.Construction of predictive model of renal injury in patients with multiple myeloma［J］.Guangdong Medicine,2021,42(7):802-805.
[11]张晓宇,张亚茹,张莹,等.血清IL-9、IL-17及IL-23水平对多发性骨髓瘤患者肾损伤的诊断价值［J］.现代肿瘤医学,2021,29(23):4201-4204. ZHANG XY,ZHANG YR,ZHANG Y,et al.The diagnostic value of serum IL-9,IL-17 and IL-23 levels in renal injury of patients with multiple myeloma［J］.Modern Oncology,2021,29(23):4201-4204.
[12]徐慈,李亚茜,项涛,等.血浆FGF23及Ang2水平预测急性呼吸窘迫综合征患者并发急性肾损伤的价值分析［J］.疑难病杂志,2021,20(11):1126-1130. XU C,LI YQ,XIANG T,et al.Analysis of the value of plasma FGF23 and Ang2 levels in predicting acute kidney injury in patients with acute respir-atory distress syndrome［J］.Journal of Critical Care Medicine,2021,20(11):1126-1130.
[13]赵伟,唐荣杰,杨珊珊,等.Klotho在盐敏感性高血压肾损伤中的作用及分子机制研究［J］.中国全科医学,2023,26(24):3042-3049. ZHAO W,TANG RJ,YANG SS,et al.The role and molecules mechanism of Klotho in renal injury in salt-sensitive hypertension［J］.Chinese General Practice,2023,26(24):3042-3049.
[14]刘竹枫,王文红,范树颖,等.Klotho蛋白对肾缺血再灌注大鼠急性肾损伤及纤维化的保护作用［J］.天津医药,2023,51(4):371-376. LIU ZF,WANG WH,FAN SY,et al.Protective effect of Klotho protein on acute renal injury and fibrosis in rats with ischemia-reperfusion［J］.Tianjin Pharmaceutical,2023,51(4):371-376.
[15]关于琳,李小悦,张杰,等.Klotho蛋白在脓毒症性急性肾损伤发病机制及诊治中研究进展［J］.创伤与急危重病医学,2023,11(2):140-142. GUAN YL,LI XY,ZHANG J,et al.Research progress of Klotho protein in pathogenesis,diagnosis and treatment of sepsis-induced acute kidney injury［J］.Trauma and Critical Care Medicine,2023,11(2):140-142.
[16]陈雅纯,黄惠莹,陆艳梅,等.妊娠高血压综合征早期肾损伤患者血清FGF23和Klotho的水平及意义［J］.河北医药,2020,42(23):3525-3528,3533. CHEN YC,HUANG HY,LU YM,et al.The detection of serum levels of FGF23 and Klotho and their significances in patients with pregnancy-induced hypertension complicated by early renal injury［J］.Hebei Pharmaceutical,2020,42(23):3525-3528,3533.
[17] MUNOZ-CASTANEDA JR,RODELO-HAAD C,PENDON-RUIZ DE MIER MV,et al.Klotho/FGF23 and Wnt signaling as important players in the comorbidities associated with chronic kidney disease［J］.Toxins(Basel),2020,12(3):185.
[18] AGORO R,WHITE KE.Regulation of FGF23 production and phosphate metabolism by bone-kidney interactions［J］.Nat Rev Nephrol,2023,19(3):185-193.
[19] CHEN Y,CHEN YX,HUANG C,et al.The clinical value of Klotho and FGF23 in cardiac valve calcification among patients with chronic kidney disease［J］.Int J Gen Med,2021,15(14):857-866.

Memo

Memo:
2022年河南省医学科技攻关计划联合共建项目（编号：LHGJ20220779）
Last Update: 2024-07-31