ЗНАЧЕНИЕ ФАКТОРА РОСТА ФИБРОБЛАСТОВ 23 (FGF-23) В ОРГАНИЗМЕ ЧЕЛОВЕКА

Авторы

  • Altynay M BALMUKHANOVA НАО «Казахский национальный медицинский университет им. С.Д. Асфендиярова»
  • Assiya B KANATBAYEVA АО «Казахский научно-исследовательский институт онкологии и радиологии»
  • Kairat A KABULBAYEV НАО «Казахский национальный медицинский университет им. С.Д. Асфендиярова»
  • Maxsot I KARASAYEV АО «Казахский научно-исследовательский институт онкологии и радиологии»
  • Dinara Zh BATYRBAYEVA НАО «Казахский национальный медицинский университет им. С.Д. Асфендиярова»

DOI:

https://doi.org/10.31082/1728-452X-2020-217-218-7-8-37-43

Ключевые слова:

фактор роста фибробластов, фосфор, паратгормон, гипертрофия левого желудочка, минерально-костные нарушения

Аннотация

На сегодняшний день хроническая болезнь почек (ХБП) занимает одно из ведущих мест среди хронических неинфекционных заболеваний по показателям заболеваемости и смертности. Одним из грозных осложнений являются минерально-костные нарушения, ухудшающие клиническое течение и прогноз пациентов. Фактор роста фибробластов 23 типа (FGF-23) – это новый биомаркер, являющийся регулятором фосфатного метаболизма и играющий важную роль в патогенезе многих осложнений при ХБП.
Цель. Изучить физиологическую роль FGF-23, а также его потенциальное клиническое влияние в прогрессировании ХБП и её осложнений.
Материал и методы. Проведен поиск литературы глубиной в 20 лет в международных научных базах PubMed/Medline, Web of Science и Google Scholar по следующим ключевым словам: «Фактор роста фибробластов 23», «FGF-23», «фосфатный гомеостаз», «хроническая болезнь почек», «минерально-костные нарушения», «гипертрофия левого желудочка».
Результаты и обсуждение. FGF-23 – это белок, секретируемый костными клетками, основная физиологическая роль которого заключается в регулировании выведения фосфатов с мочой для поддержания их стабильного уровня в сыворотке крови. Более того, FGF-23 снижает уровень кальцитриола и ингибирует секрецию паратиреоидного гормона. При ХБП отмечается постепенное повышение уровня FGF-23 по мере снижения почечной функции, что может расцениваться как физиологическая компенсация для стабилизации уровня фосфора в сыворотке крови. По данным различных исследований FGF-23 может также ассоциироваться и с кардиоваскулярными осложнениями, такими как гипертрофия левого желудочка и сердечная недостаточность.
Выводы. Таким образом, FGF-23 – это не только маркер минерально-костных нарушений при ХБП, но и ключевое звено в патогенезе развития вторичного гиперпаратиреоза и кардиоваскулярных осложнений. Учитывая это, FGF-23 может представлять собой полифункциональную терапевтическую мишень, которая может улучшить прогноз жизни пациентов с ХБП.

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2020-08-07

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