en ارتباط میان فاکتور رشد فیبروبلاست 23 و پروتئین واکنشی C در بیماران تحت همودیالیز عمومى General پژوهشي Research <span style="font-size:11pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><b><span lang="FA" style="font-size:9.0pt"><span b="" style="font-family:" zar="">مقدمه</span></span></b><span lang="AR-SA" style="font-size:9.0pt"><span style="background:white"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:.1pt">: </span></span></span></span></span><span lang="FA" style="font-size:9.0pt"><span b="" style="font-family:" zar="">سطوح فاکتور رشد فیبروبلاست 23 (</span></span><span dir="LTR" style="font-size:8.0pt"><span new="" roman="" style="font-family:" times="">FGF23</span></span><span lang="FA" style="font-size:9.0pt"><span b="" style="font-family:" zar="">) و مارکرهای التهابی معمولاً در </span></span><span dir="LTR" style="font-size:8.0pt"><span new="" roman="" style="font-family:" times="">ESRD</span></span><span lang="FA" style="font-size:9.0pt"><span b="" style="font-family:" zar=""> افزایش می‌یابد و هریک با نتایج بالینی نامطلوب همراه است. این مطالعه این فرضیه را آزمایش می‌کند که </span></span><span dir="LTR" style="font-size:8.0pt"><span new="" roman="" style="font-family:" times="">FGF23</span></span><span lang="FA" style="font-size:9.0pt"><span b="" style="font-family:" zar=""> به‌طور مستقل، با پروتئین واکنشی </span></span><span dir="LTR" style="font-size:8.0pt"><span new="" roman="" style="font-family:" times="">C</span></span><span lang="FA" style="font-size:9.0pt"><span b="" style="font-family:" zar=""> در </span></span><span dir="LTR" style="font-size:8.0pt"><span new="" roman="" style="font-family:" times="">ESRD</span></span><span lang="FA" style="font-size:9.0pt"><span b="" style="font-family:" zar=""> مرتبط است.</span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><b><span lang="FA" style="font-size:9.0pt"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:.1pt">مواد و روش ها:</span></span></span></span></b> <span lang="FA" style="font-size:9.0pt"><span b="" style="font-family:" zar="">این مطالعۀ مقطعی روی 254 بیمار </span></span><span dir="LTR" style="font-size:8.0pt"><span new="" roman="" style="font-family:" times="">ESRD</span></span><span lang="FA" style="font-size:9.0pt"><span b="" style="font-family:" zar=""> تحت درمان با همودیالیز انجام‌شده است. روش نمونه‌گیری به‌صورت تمام‌شماری بوده است، بدین‌صورت که همۀ بیماران </span></span><span dir="LTR" style="font-size:8.0pt"><span new="" roman="" style="font-family:" times="">ESRD</span></span><span lang="FA" style="font-size:9.0pt"><span b="" style="font-family:" zar=""> تحت همودیالیز در مرکز همودیالیز بیمارستان رازی در شهر رشت، در سال 1396 وارد مطالعه شدند. برای تجزیه تحلیل داده‌ها از آزمون شاپیرو ویلک، ضریب همبستگی اسپیرمن و رگرسیون خطی استفاده گردید و تجزیه تحلیل داده‌ها با نرم‌افزار </span></span><span dir="LTR" style="font-size:8.0pt"><span new="" roman="" style="font-family:" times="">SPSS vol.26</span></span><span lang="FA" style="font-size:9.0pt"><span b="" style="font-family:" zar=""> انجام شد.</span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><b><span lang="FA" style="font-size:9.0pt"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.1pt">یافته‌ها:</span></span></span></span></b> <span lang="FA" style="font-size:9.0pt"><span b="" style="font-family:" zar="">میانۀ سن بیماران 60 سال (49-69) و 9/57 درصد مرد و میانگین و میانۀ </span></span><span dir="LTR" style="font-size:8.0pt"><span new="" roman="" style="font-family:" times="">iFGF23</span></span><span lang="FA" style="font-size:9.0pt"><span b="" style="font-family:" zar=""> در بیماران به‌ترتیب 6/14</span></span><span lang="FA" style="font-size:9.0pt"><span cambria="" style="font-family:">&plusmn;</span></span><span lang="FA" style="font-size:9.0pt"><span b="" style="font-family:" zar="">5/59 و 62 </span></span><span dir="LTR" style="font-size:8.0pt"><span new="" roman="" style="font-family:" times="">pg/ml</span></span><span lang="FA" style="font-size:9.0pt"><span b="" style="font-family:" zar=""> (70-50)؛ همچنین میانۀ فاکتور </span></span><span dir="LTR" style="font-size:8.0pt"><span new="" roman="" style="font-family:" times="">CRP</span></span><span lang="FA" style="font-size:9.0pt"><span b="" style="font-family:" zar=""> برابر با 4 </span></span><span dir="LTR" style="font-size:8.0pt"><span new="" roman="" style="font-family:" times="">mg/l</span></span><span lang="FA" style="font-size:9.0pt"><span b="" style="font-family:" zar=""> (11-1) بود. درصد </span></span><span dir="LTR" style="font-size:8.0pt"><span new="" roman="" style="font-family:" times="">CRP</span></span><span lang="FA" style="font-size:9.0pt"><span b="" style="font-family:" zar=""> مثبت در بیماران مطالعه‌شده 9/72 درصد، میانگین و انحراف معیار در موارد مثبت 82/8</span></span><span lang="FA" style="font-size:9.0pt"><span cambria="" style="font-family:">&plusmn;</span></span><span lang="FA" style="font-size:9.0pt"><span b="" style="font-family:" zar="">94/12 به‌دست آمد. در تحلیل رگرسیون خطی چندگانه، پس از کنترل اثر متغیرهای مخدوش‌کننده (متغیر‌های فردی، مؤلفه‌های خونی و بیماری‌های زمینه‌ای) مشاهده شد که میان </span></span><span dir="LTR" style="font-size:8.0pt"><span new="" roman="" style="font-family:" times="">iFGF23</span></span><span lang="FA" style="font-size:9.0pt"><span b="" style="font-family:" zar=""> و </span></span><span dir="LTR" style="font-size:8.0pt"><span new="" roman="" style="font-family:" times="">CRP</span></span><span lang="FA" style="font-size:9.0pt"><span b="" style="font-family:" zar=""> ارتباط مستقیم و معنا‌داری وجود دارد (</span></span><span dir="LTR" style="font-size:8.0pt"><span new="" roman="" style="font-family:" times="">P=0.010</span></span><span lang="FA" style="font-size:9.0pt"><span b="" style="font-family:" zar="">، </span></span><span dir="LTR" style="font-size:8.0pt"><span new="" roman="" style="font-family:" times="">&beta;=0.129</span></span> <span lang="FA" style="font-size:9.0pt"><span b="" style="font-family:" zar="">، </span></span><span dir="LTR" style="font-size:8.0pt"><span new="" roman="" style="font-family:" times="">CI=0.032-0.226</span></span><span lang="FA" style="font-size:9.0pt"><span b="" style="font-family:" zar="">).</span></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span calibri="" style="font-family:"><b><span lang="FA" style="font-size:9.0pt"><span b="" style="font-family:" zar=""><span style="color:black"><span style="letter-spacing:-.1pt">بحث و نتیجه‌گیری:</span></span></span></span></b> <span lang="FA" style="font-size:9.0pt"><span b="" style="font-family:" zar="">مطالعۀ حاضر نشان داد که افزایش سطح </span></span><span dir="LTR" style="font-size:8.0pt"><span new="" roman="" style="font-family:" times="">FGF23</span></span><span lang="FA" style="font-size:9.0pt"><span b="" style="font-family:" zar=""> به‌طور مستقل، با افزایش سطح </span></span><span dir="LTR" style="font-size:8.0pt"><span new="" roman="" style="font-family:" times="">CRP</span></span><span style="font-size:9.0pt"><span b="" style="font-family:" zar=""> در بیماران مبتلا به </span></span><span dir="LTR" style="font-size:8.0pt"><span new="" roman="" style="font-family:" times="">ESRD</span></span><span style="font-size:9.0pt"><span b="" style="font-family:" zar=""> ارتباط دارد. مطالعات آینده باید ارزیابی کنند که آیا التهاب ارتباط میان افزایش سطح </span></span><span dir="LTR" style="font-size:8.0pt"><span new="" roman="" style="font-family:" times="">FGF23</span></span><span style="font-size:9.0pt"><span b="" style="font-family:" zar=""> و پیامدهای بالینی نامطلوب در </span></span><span dir="LTR" style="font-size:8.0pt"><span new="" roman="" style="font-family:" times="">ESRD</span></span> <span lang="FA" style="font-size:9.0pt"><span b="" style="font-family:" zar="">را تغییر می‌دهد یا خیر.</span></span></span></span></span></span></span><br> &nbsp; <div><span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="letter-spacing:-.1pt">Introduction:</span></span></span></span></b> <span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">Fibroblast growth factor 23 (FGF23) levels and inflammatory markers are usually elevated in End-Stage Renal Disease ESRD, and each is associated with adverse clinical outcomes. This study aimed to investigate the hypothesis that FGF23 was independently associated with C-reactive protein in ESRD.</span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="letter-spacing:.1pt">Material & Methods:</span></span></span></span></b> <span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">This cross-sectional study was performed on 254 ESRD patients undergoing hemodialysis. The sampling method was census so that all ESRD patients undergoing hemodialysis in the hemodialysis center of Razi Hospital, Rasht, Iran, in 2017, were included in the study. Data analysis was performed using SPSS software (version 26) through the Shapiro-Wilk test, Spearman correlation multiplication, and linear regression.</span></span></span></span></span><br> <span style="line-height:normal"><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="letter-spacing:-.1pt">(Ethic </span></span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="letter-spacing:.1pt">code</span></span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="letter-spacing:-.1pt">: IR.GUMS.REC.1396.123)</span></span></span><span style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="letter-spacing:-.1pt">Findings:</span></span></span></span></b> <span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">The median age of the patients was 60 years (age range: 49-69), and 57.9% of the cases were male. The mean and median amount of iFGF23 in patients were 59.5&plusmn;14.6 and 62 pg/ml (50-70), respectively. Moreover, the median amount of CRP factor was 4 mg/l (1-11). The percentage of positive CRP in the studied patients was 72.9%, while the mean amount and standard deviation in the positive cases were 12.94&plusmn;8.82. In multiple linear regression analysis, after controlling the effect of confounding variables (individual variables, blood parameters, and underlying diseases), there was a direct and significant relationship between iFGF23 and CRP (P=0.010, </span></span><span style="font-size:10.0pt"><span cambria="" math="" style="font-family:">𝜷</span></span><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">=0.129, CI=0.032-0.226).</span></span></span></span></span><br> <span style="font-size:11pt"><span style="line-height:normal"><span calibri="" style="font-family:"><b><span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black"><span style="letter-spacing:.1pt">Discussion & Conclusion:</span></span></span></span></b> <span style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">The present study showed that increased FGF23 levels are independently associated with increased CRP levels in patients with ESRD. Future studies should evaluate whether inflammation alters the association between elevated FGF23 levels and adverse clinical outcomes in ESRD.</span></span></span></span></span><br> &nbsp;</div> بیماران همودیالیزی, پروتئین واکنشی C, فاکتور رشد فیبروبلاست 23, مرحلۀ آخر بیماری کلیوی C-reactive protein, End-stage renal disease, Fibroblast growth factor-23, Hemodialysis patients 65 73 http://sjimu.medilam.ac.ir/browse.php?a_code=A-10-6938-1&slc_lang=en&sid=1 Elham Ramezanzade الهام رمضان زاده rz.elham58@gmail.com 9600319475328460044918 9600319475328460044918 No Dept of Nephrology, Razi Clinical Research Development Unit, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran گروه نفرولوژی، مرکز تحقیقات توسعۀ بالینی رازی، بیمارستان رازی، دانشکدۀ پزشکی، دانشگاه علوم پزشکی گیلان، رشت، ایران Salman Nikfarjam سلمان نیک فرجام dr.cardiolog58@yahoo.com 9600319475328460044919 9600319475328460044919 Yes Dept of Cardiology, Cardiovascular Diseases Research Center, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran گروه قلب و عروق، مرکز تحقیقات بیماری‌های قلب و عروق، بیمارستان حشمت، دانشکدۀ پزشکی، دانشگاه علوم پزشکی گیلان، رشت، ایران Masoomeh Namdar معصومه نامدار mtaleshani@gmail.com 9600319475328460044920 9600319475328460044920 No Dept of Nephrology, Razi Clinical Research Development Unit, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran گروه نفرولوژی، مرکز تحقیقات توسعۀ بالینی رازی، بیمارستان رازی، دانشکدۀ پزشکی، دانشگاه علوم پزشکی گیلان، رشت، ایران Fatemeh nejatifar فاطمه نجاتی فر dr.f.nejatifar@gmail.com 9600319475328460044921 9600319475328460044921 No Razi Clinical Research Development Unit, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran گروه داخلی، مرکز تحقیقات توسعه بالینی رازی، بیمارستان رازی، دانشکدۀ پزشکی، دانشگاه علوم پزشکی گیلان، رشت، ایران