Altered serum levels of FGF-23 and magnesium are independent risk factors for an increased albumin-to-creatinine ratio in type 2 diabetics with chronic kidney disease

Silva, Ana Paula; Mendes, Filipa; André, Fabrice; Jerónimo, Teresa; Pimentel, Ana Laura; Gundlach, Kristina; Büchel, Janine; Santos, Nélio; Neves, Pedro Leão

doi:10.1016/j.jdiacomp.2015.11.006

Cited by 8 publications

(6 citation statements)

References 45 publications

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“…This is in agreement with previous studies reporting that FGF-23 was also found to be a predictor of CKD progression in diabetic 35 and non-diabetic patients. 36 Interestingly, numerous data on pleotropic effects of FGF-23 is also emerging, namely the association of elevated FGF-23 levels with multiple cardiovascular risk factors [37][38][39] and mortality. 40 All together, this makes FGF-23 a potential biomarker of multiple disarrangements leading to negative patient outcome.…”

Section: Discussionmentioning

confidence: 99%

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FGF23-klotho axis as predictive factors of fractures in type 2 diabetics with early chronic kidney disease

Ribeiro

Mendes

Carias

et al. 2020

Journal of Diabetes and its Complications

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Background: The aim of our study was to evaluate the relevance of FGF23-klotho axis in the predisposition for bone fractures in type 2 diabetic patients with early chronic kidney disease. Methods: In a prospective study we included 126 type 2 diabetic patients with CKD stages 2-3 (from 2010 to 2017). We used descriptive statistics, ANOVA and chi-square test. Our population was divided into two groups according to the occurrence of a bone fracture event or not, and the groups were compared considering several biological and laboratorial parameters. We employed a multiple regression model to identify risk factors for bone fracture events and hazard ratios (HR) were calculated using a backward stepwise likelihood ratio (LR) Cox regression. Results: Patients with a fracture event displayed higher levels of FGF-23, Phosphorus, PTH, TNF-α, OxLDL, HOMA-IR, calcium × phosphorus product and ACR and lower levels of Osteocalcin, α-Klotho, 25(OH)D3 and eGFR compared with patients without a fracture event (p b 0.001). The number of patients with a fracture event was higher than expected within inclining CKD stages (χ2, p = 0.06). The occurrence of fracture and the levels of TNF-α, klotho, 25(OH)D3 and OxLDL were found to predict patient entry into RRT (p b 0.05). Age, osteocalcin, α-Klotho and FGF-23 independently influenced the occurrence of bone fracture (p b 0.05). Conclusions: α-Klotho and FGF-23 levels may have a good clinical use as biomarkers to predict the occurrence of fracture events.

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Section: Discussionmentioning

confidence: 99%

“…(Pearson Chi-Square, p = 006). The patients were classified into three stages of CKD, according to the eGFR (mL/min/1.73 m 2 ): CKD 2 (60-89), CKD 3a(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59) and CKD 3b(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44).…”

mentioning

confidence: 99%

FGF23-klotho axis as predictive factors of fractures in type 2 diabetics with early chronic kidney disease

Ribeiro

Mendes

Carias

et al. 2020

Journal of Diabetes and its Complications

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“…More than 30% of T2D patients have hypomagnesemia, mainly caused by enhanced renal excretion. Magnesium deficiency induces endothelial cell dysfunction, inflammation, and oxidative stress [ 272 - 275 ]. Thus, hypomagnesemia may be a modifiable risk factor of DN.…”

Section: Diabetic Nephropathymentioning

confidence: 99%

The Role of Biofactors in Diabetic Microvascular Complications

Ziegler

Porta

Παπάνας

et al. 2022

CDR

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: Microvascular complications are responsible for a major proportion of the burden associated with diabetes contributing to substantial morbidity, mortality, and healthcare costs in people with diabetes. Retinopathy, nephropathy, and neuropathy constitute the leading causes of blindness, end-stage renal disease, and lower-extremity amputations, respectively. Since the efficacy of causal therapies of diabetic microvascular complications is limited, especially in type 2 diabetes, there is an unmet need for adjunct treatments which should be effective despite ongoing hyperglycemia. Experimental studies indicate that diabetic microvascular complications can be prevented or ameliorated by various biofactors in animal models by interfering with the pathophysiology of the underlying condition. Some of the findings related to biofactors like α-lipoic acid and benfotiamine could be translated into the clinical arena and confirmed in clinical trials, especially in those focusing on diabetic polyneuropathy. Given the micronutrient nature of these compounds, their safety profile is excellent. Thus, they have the potential to favorably modify the natural history of the underlying complication, but large long-term clinical trials are required to confirm this notion. Ultimately, biofactors should expand our therapeutic armamentarium against these common, debilitating, and even life-threatening sequelae of diabetes.

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“…Fibroblast growth factor-23 (FGF-23) is a hormone that plays an important role in vitamin D and phosphate homeostasis [ 77 ]. In patients with T2DM and CKD, increased serum FGF-23 levels were associated with macroalbuminuria and creatinine levels [ 77 , 78 , 79 , 80 ]. In addition, serum FGF-23 levels predicted an increased risk for DKD progression [ 81 ].…”

Section: Fibroblast Growth Factor-23mentioning

confidence: 99%

Novel Cardiovascular Risk Factors in Patients with Diabetic Kidney Disease

Kourtidou

Stangou

Marinaki

et al. 2021

IJMS

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Patients with diabetic kidney disease (DKD) are at very high risk for cardiovascular events. Only part of this increased risk can be attributed to the presence of diabetes mellitus (DM) and to other DM-related comorbidities, including hypertension and obesity. The identification of novel risk factors that underpin the association between DKD and cardiovascular disease (CVD) is essential for risk stratification, for individualization of treatment and for identification of novel treatment targets.In the present review, we summarize the current knowledge regarding the role of emerging cardiovascular risk markers in patients with DKD. Among these biomarkers, fibroblast growth factor-23 and copeptin were studied more extensively and consistently predicted cardiovascular events in this population. Therefore, it might be useful to incorporate them in risk stratification strategies in patients with DKD to identify those who would possibly benefit from more aggressive management of cardiovascular risk factors.

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Altered serum levels of FGF-23 and magnesium are independent risk factors for an increased albumin-to-creatinine ratio in type 2 diabetics with chronic kidney disease

Cited by 8 publications

References 45 publications

FGF23-klotho axis as predictive factors of fractures in type 2 diabetics with early chronic kidney disease

FGF23-klotho axis as predictive factors of fractures in type 2 diabetics with early chronic kidney disease

The Role of Biofactors in Diabetic Microvascular Complications

Novel Cardiovascular Risk Factors in Patients with Diabetic Kidney Disease

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