Objective To investigate the correlation between serum fibroblast growth factor 23(FGF23)and D-ser-ine(D-ser)levels and hearing impairment in maintenance hemodialysis(MHD)patients.Methods Forty MHD patients with combined hearing impairment admitted to the Department of Nephrology of Shanghai Fifth People's Hospital Affiliated to Fu-dan University from January 2021 to December 2023 were selected as the hearing-impaired group,40 MHD patients without combined hearing impairment were selected as the non-hearing-impaired group,and 40 healthy patients with physical exami-nation were selected as the healthy control group;Serum FGF23 and D-ser levels were measured by enzyme-linked immu-nosorbent assay with high performance liquid chromatography fluorescence;The correlation between serum FGF23 and D-ser levels and PTA in MHD patients was analyzed by Spearman/Pearson correlation coefficients,the factors of hearing im-pairment in MHD patients were analyzed by multifactorial logistic regression,and the predictive value of serum FGF23 and D-ser levels for hearing impairment in MHD patients was analyzed by ROC curves.Results Serum FGF23 and D-ser levels were higher in the hearing-impaired group than in the non-hearing-impaired group and the control group,and serum FGF23 and D-ser levels were higher in the non-hearing-impaired group than in the control group(F/P=69.767/＜0.001,307.552/0.001).Spearman/Pearson correlation showed a positive correlation between serum FGF23 and D-ser levels and PTA in pa-tients with MHD(r/P=0.649/＜0.001,0.669/＜0.001).Multifactorial logistic regression showed that prolonged dialysis age,elevated FGF23,and elevated D-ser were independent risk factors for hearing impairment in MHD patients[OR(95％CI)=1.036(1.007-1.065),1.018(1.006-1.029),and 1526(1.145-2.033)];The ROC curves showed that the area under the curve(AUC)of serum FGF23,D-ser levels and the combination of the two predicted hearing impairment in MHD patients were 0.773,0.788,0.880,respectively,and that the combination of the two was greater than the AUCs predicted by each of the se-rum FGF23 and D-ser levels alone(Z=2.409,2344,P=0.016,0.019).Conclusion Elevated serum FGF23 and D-ser levels in MHD patients are independent risk factors for hearing impairment,and the combined serum FGF23 and D-ser levels are of high value in predicting hearing impairment in MHD patients.
Maintenance hemodialysisHearing impairmentFibroblast growth factor 23D-serinePredictive value
维普
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