Is fibroblast growth factor 23 a new cardiovascular risk marker in gestational diabetes?

Kızılgül, Muhammed; Kan, Seyfullah; Beysel, Selvihan; Apaydın, Mahmut; Ozcelik, Ozgur; Çalışkan, Mustafa; Özbek, Mustafa; Özdemir, Şeyda

doi:10.1590/2359-3997000000287

Cited by 9 publications

(10 citation statements)

References 41 publications

(35 reference statements)

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“…It also participates in cardiovascular disturbances, including atherosclerosis and left ventricular hypertrophy [137, 138]. Notably, FGF-23 estimated adverse cardiovascular outcomes in women with T2DM [139], and also, high levels of FGF-23 (and low of adiponectin) diagnosed GDM at the 3rd trimester [140] (Table 4). Placenta-secreted factors…”

Section: Prospective Diagnostic and Predictive Markers For Gdm With Amentioning

confidence: 99%

Predictive and diagnostic biomarkers for gestational diabetes and its associated metabolic and cardiovascular diseases

Lorenzo-Almorós

Hang

Peiró

et al. 2019

Cardiovasc Diabetol

116

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Gestational diabetes mellitus (GDM) is defined as the presence of high blood glucose levels with the onset, or detected for the first time during pregnancy, as a result of increased insulin resistance. GDM may be induced by dysregulation of pancreatic β-cell function and/or by alteration of secreted gestational hormones and peptides related with glucose homeostasis. It may affect one out of five pregnancies, leading to perinatal morbidity and adverse neonatal outcomes, and high risk of chronic metabolic and cardiovascular injuries in both mother and offspring. Currently, GDM diagnosis is based on evaluation of glucose homeostasis at late stages of pregnancy, but increased age and bodyweight , and familiar or previous occurrence of GDM, may conditionate this criteria. In addition, an earlier and more specific detection of GDM with associated metabolic and cardiovascular risk could improve GDM development and outcomes. In this sense, 1st-2nd trimester-released biomarkers found in maternal plasma including adipose tissue-derived factors such as adiponectin, visfatin, omentin-1, fatty acid-binding protein-4 and retinol binding-protein-4 have shown correlations with GDM development. Moreover, placenta-related factors such as sex hormone-binding globulin, afamin, fetuin-A, fibroblast growth factors-21/23, ficolin-3 and follistatin, or specific micro-RNAs may participate in GDM progression and be useful for its recognition. Finally, urine-excreted metabolites such as those related with serotonin system, non-polar amino-acids and ketone bodies, may complete a predictive or earlydiagnostic panel of biomarkers for GDM.

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Section: Prospective Diagnostic and Predictive Markers For Gdm With Amentioning

confidence: 99%

Predictive and diagnostic biomarkers for gestational diabetes and its associated metabolic and cardiovascular diseases

Lorenzo-Almorós

Hang

Peiró

et al. 2019

Cardiovasc Diabetol

116

View full text Add to dashboard Cite

show abstract

“…FGF-23 requires a cofactor known as α-Klotho, protects the heart, for activation of FGF signaling. [33] Increased FGF-23 levels were observed in patients with gestational DM [34] and FGF-23 levels are associated with bone mineral density and preclinical vascular disease in patients Type 2 DM. [35] Ito et al [36] reported that FGF-23 levels were decreased in patients with acromegaly after surgery.…”

Section: Discussionmentioning

confidence: 99%

Association Between Coronary Flow Reserve, Klotho and Fibroblast Growth Factor 23 in Patients with Acromegaly

Takır

Aysu

2018

EJMO

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A cromegaly is a chronic endocrine disorder that is characterized by hypersecretion of growth hormone (GH) and, consequentially, insulin-like growth factor-1 (IGF-1). The most common cause of acromegaly is a pituitary adenoma. [1] Prolonged exposure to excess plasma levels of GH and IGF-1 causes progressive somatic disfigurement and many systemic manifestations. The estimated annual incidence is 3-4 new cases per year and prevalence is between 40 and 70 per million. [1, 2] Cardiovascular disease is the leading cause of morbidity and mortality in acromegaly. [3] Long-term exposure to high levels of GH and IGF-1 causes the development of "acromegalic cardiomyopathy" characterized by concentric biventricular hypertrophy. [4-6] It mainly involves the left ventricle, causes diastolic dysfunction and progresses to systolic dysfunction and heart failure in case of inadequate treatment. [4] Hypertension (HT), valvular diseases, and arrhythmias are additional complications of acromegaly contributing to the worsening of cardiac functions. [7-11] Furthermore, metabolic complications such as insulin resistance, diabetes mellitus (DM), and hyperlipidemia are frequently seen in acromegaly, and these disorders contribute to increased cardiovascular Objectives: Acromegaly is a chronic endocrine disorder that is characterized by hypersecretion of growth hormone. The purpose of this study was to evaluate coronary flow reserve (CFR) in patients with acromegaly and investigate whether there is an association between fibroblast growth factor-23 (FGF-23) and Klotho levels with coronary microcirculation or not. Methods: A total of 54 patients with acromegaly were divided into subgroups: Those with active disease and those who are in biochemical remission (serum insulin-like growth factor-1 level was within the normal range). Along with 31 healthy volunteers, the patients underwent dipyridamole-stress transthoracic Doppler echocardiography. CFR was calculated with the ratio of hyperemic to baseline diastolic peak velocities. Klotho and FGF-23 were measured using an enzyme-linked immunosorbent assay. Results: A total of 42 (%77.8) of acromegaly patients had active disease. Acromegaly patients had lower Klotho and FGF-23 levels compared to in controls. Patients with active disease had higher FGF-23 levels and lower Klotho levels when compared to patients in remission. CFR levels of active group were lower than remission and controls (p=0.001; p=0.043, respectively). Klotho was strongly associated with CFR levels in patients with active disease (r=0.8, p=0.001). Conclusion: Acromegaly patients have lower levels of Klotho and FGF-23 and CFR.

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“…Most of them are focused on blood glucose monitoring for the management of GDM [72][73][74], and not on the prediction of post load glycemia as an early detection or alternative screening tool for this pregnancy disorder. Furthermore, although some of them evaluate the correlation between different variables and fasting glycemia [75][76][77], postprandial glycemia [78], glucose challenge test (GCT) post load glycemia [79,80] and OGTT post load glycemia [81][82][83], they don't test their predictive performance through error metrics like RMSE and RE. To our knowledge, this is the first study that introduces and properly assesses ML models to predict OGTT post load glycemia so as to make the early detection and screening of GDM independent of the diagnostic criteria.…”

Section: Plos Onementioning

confidence: 99%

Evaluation of first and second trimester maternal thyroid profile on the prediction of gestational diabetes mellitus and post load glycemia

et al. 2023

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Maternal thyroid alterations have been widely associated with the risk of gestational diabetes mellitus (GDM). This study aims to 1) test the first and the second trimester full maternal thyroid profile on the prediction of GDM, both alone and combined with non-thyroid data; and 2) make that prediction independent of the diagnostic criteria, by evaluating the effectiveness of the different maternal variables on the prediction of oral glucose tolerance test (OGTT) post load glycemia. Pregnant women were recruited in Concepción, Chile. GDM diagnosis was performed at 24–28 weeks of pregnancy by an OGTT (n = 54 for normal glucose tolerance, n = 12 for GDM). 75 maternal thyroid and non-thyroid parameters were recorded in the first and the second trimester of pregnancy. Various combinations of variables were assessed for GDM and post load glycemia prediction through different classification and regression machine learning techniques. The best predictive models were simplified by variable selection. Every model was subjected to leave-one-out cross-validation. Our results indicate that thyroid markers are useful for the prediction of GDM and post load glycemia, especially at the second trimester of pregnancy. Thus, they could be used as an alternative screening tool for GDM, independently of the diagnostic criteria used. The final classification models predict GDM with cross-validation areas under the receiver operating characteristic curve of 0.867 (p<0.001) and 0.920 (p<0.001) in the first and the second trimester of pregnancy, respectively. The final regression models predict post load glycemia with cross-validation Spearman r correlation coefficients of 0.259 (p = 0.036) and 0.457 (p<0.001) in the first and the second trimester of pregnancy, respectively. This investigation constitutes the first attempt to test the performance of the whole maternal thyroid profile on GDM and OGTT post load glycemia prediction. Future external validation studies are needed to confirm these findings in larger cohorts and different populations.

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Is fibroblast growth factor 23 a new cardiovascular risk marker in gestational diabetes?

Cited by 9 publications

References 41 publications

Predictive and diagnostic biomarkers for gestational diabetes and its associated metabolic and cardiovascular diseases

Predictive and diagnostic biomarkers for gestational diabetes and its associated metabolic and cardiovascular diseases

Association Between Coronary Flow Reserve, Klotho and Fibroblast Growth Factor 23 in Patients with Acromegaly

Evaluation of first and second trimester maternal thyroid profile on the prediction of gestational diabetes mellitus and post load glycemia

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