Elevated serum fibroblast growth factor 23 levels as an indicator of lower extremity atherosclerotic disease in Chinese patients with type 2 diabetes mellitus

Abstract

BackgroundRecently, basic and clinical studies have provided evidence supporting the relationship between circulating levels of fibroblast growth factor (FGF) 23 and the development of atherosclerosis. Given that diabetes is an established risk factor for lower extremity atherosclerotic disease (LEAD), the goal of the present study was to explore the relationship between serum FGF23 levels and LEAD, as well as the related factors, in Chinese patients with type 2 diabetes mellitus (T2DM).MethodsA total of 401 hospitalized T2DM patients (201 subjects with LEAD and 200 subjects without LEAD) were enrolled in this study. Serum FGF23 levels were determined by a sandwich enzyme-linked immunosorbent assay. Femoral intima-media thickness (F-IMT) and lower limb atherosclerotic plaque were assessed through color Doppler ultrasound.ResultsThe median (interquartile range) serum FGF23 levels in the entire study population was 42.08 (35.59–49.17) pg/mL. Subjects with LEAD had significantly higher serum FGF23 levels compared with those without LEAD (44.00 [37.54–51.30] pg/mL versus 40.42 [32.61–48.23] pg/mL, P < 0.001). Logistic regression showed that serum FGF23 levels were independently and positively correlated with the presence of LEAD (odds ratio 1.039, 95% confidence interval 1.012–1.067, P = 0.004). In addition, multiple liner regression analysis revealed that serum FGF23 levels were positively associated with F-IMT (standardized β = 0.175, P < 0.001). Furthermore, this relationship remained significant after additional adjustment for gender and factors potentially affecting serum FGF23 levels (serum calcium, serum phosphorus, and glomerular filtration rate), respectively (both P < 0.01).ConclusionsIn Chinese patients with T2DM, serum FGF23 levels were independently and positively correlated with the presence of LEAD.

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Impact of Osteocalcin Level on Vascular Calcification in Type 2 Diabetics in Relation to Fibroblast Growth Factor-23(FGF-23)

“…So FGF-23 have a role in the development of vascular calcifications (64) . The increment in the circulating FGF-23 levels, which was also noticed in the diabetic animal models, may escalate the existing endothelial dysfunction and induce a vascular calcification, subsequently, resulting in atherosclerosis in DM patients (65) .…”

Association of serum Cyr61 levels with peripheral arterial disease in patients with type 2 diabetes

“…Recent years, several potential biomarkers were found to identify PAD in diabetic patients. For instance, serum high mobility group box 1 (HMGB1), broblast growth factor (FGF) 23 and osteopontin (OPN) have been correlated with the presence of PAD in diabetic patients [24,25]. In addition, thrombospondin-4 (TSP-4) levels were signi cantly increased with PAD severity in patients with concomitant diabetes and could be a novel marker of atherosclerotic activity [26].…”