Objective To study the changes of peripheral blood fibroblast growth factor‐23(FGF‐23)level and its significance in the patients with early stage of type 2 diabetic nephropathy(T2DN) .Methods 98 outpatients and inpatients with type 2 diabetic mellitus(T2DM)in our hospital from March 2012 to November 2013 were divided into the simple DM group(31 cases) ,early diabetic nephropathy(DN)group(34 cases)and clinical DN group(33 cases) .30 healthy individuals were selected as the control group .Peripheral blood FGF‐23 level was detected by enzyme‐linked immunosorbent assay(ELISA) .Serum CysC ,P and Ca were measured in the same time .And eGRF was calculated based on height ,weight ,age ,gender and serum creatinine .Results The FGF‐23 and CysC levels in each group of T2DM were significantly higher thatn those in the healthy control group and eGFR was significantly lower than that in the healthy control group(P<0 .05 ,P<0 .01) .Compared with those in the simple DM group ,the FGF‐23 and Cy‐sC levels in the early DN group were significantly increased and eGFR was significantly decreased(P< 0 .05);the FGF‐23 and CysC levels in the clinical DN group were further increased compared with those in early DN group and eGFR was further reduced(P< 0 .01) .The serum P level had no statistical differences among the healthy control group ,simple DM group and early DN group(P>0 .05) .But serum P level and the product of Ca × P in the clinical DN group were significantly higher than those in the other groups(P<0 .01) .The correlation analysis showed that the FGF‐23 level in the DN patients was positively correlated with the CysC and P levels(P<0 .01)and negatively correlated with eGFR(P<0 .01) ,but there were no correlation between FGF‐23 with age ,BMI and Ca(P>0 .05) . Conclusion The increase of peripheral blood FGF‐23 level in early T2DN is earlier than the changes of Ca and P ,mo‐reover the FGF‐23 level is gradually increased with DN progress .FGF‐23 can be used as one of the effective indexes of early T2DN diagnosis and may become as the warning indicator to T2DN progress .%目的：研究早期2型糖尿病肾病（T2DN）患者外周血成纤维细胞生长因子（FGF‐23）水平的变化及临床意义。方法2012年3月至2013年11月该院门诊及住院治疗的2型糖尿病（T2DM）患者98例，其中单纯糖尿病（DM）组31例，早期糖尿病肾病（DN）组34例，临床DN组33例，并选健康者30例作为健康对照组。采用酶联免疫吸附试验测定外周血FGF‐23水平，同时测定血胱抑素C（CysC）、血磷（P）、血钙（Ca），并计算P和Ca乘积，根据年龄、性别和血肌酐估算肾小球滤过率（eGRF）。结果各组T2DM患者FGF‐23、CysC明显高于健康对照组，eGFR明显低于健康对照组（P＜0．05）；与单纯DM组比较，早期DN组FGF‐23、CysC明显升高，eGFR明显降低（P＜0．05）；临床DN组与早期DN组比较，FGF‐23、CysC进一步升高，eGFR进一步降低，差异有统计学意义（P＜0．01）。血P在健康对照组、单纯DM组及早期DN组中差异无统计学意义（P＞0．05），临床DN组血P及Ca×P值则较其他组明显升高，差异有统计学意义（P＜0．01）。相关性分析显示，DN患者FGF‐23水平与CysC、P呈正相关（P＜0．01），与eGFR呈负相关（P＜0．01），与年龄、体质量指数、Ca等无相关性（P＞0．05）。结论早期T2DN外周血FGF‐23水平的升高早于Ca和P的变化，且随DN进展，FGF‐23水平逐渐升高，FGF‐23可作为早期T2DN诊断的有效指标之一，并可成为T2DN进展的预警指标。
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