Assessment of fibroblast growth factor 23 in relation to peripheral arterial disease in type 2 diabetes mellitus

Abstract

Background Peripheral arterial disease (PAD) is a major vascular complication and the leading cause of amputation in people with diabetes. Fibroblast growth factor 23 (FGF-23) is a recently discovered 30-kD secreted hormone glycoprotein that plays a role in the complex and tightly regulated mechanisms of mineral metabolism. Increase in serum FGF-23 concentration was an independent predictor of coronary artery diseases in patients with mild chronic kidney disease and of mortality in patients undergoing hemodialysis. Recently, FGF-23 has been found to be associated with total body atherosclerosis and vascular dysfunction. Objective To evaluate the relation between FGF-23 and PAD in patients having type 2 diabetes with normal kidney function. Patients and methods A case–control study was conducted on 120 diabetic patients, where 60 patients having type 2 diabetes with PAD were compared with 60 patients having type 2 diabetes without PAD. All patients were subjected to full history taking, thorough clinical examination, ankle-brachial index assessment, and laboratory measurement of glycated hemoglobin%, estimated glomerular filtration rate, microalbuminuria, lipid profile, serum ionized calcium and phosphorous, and serum FGF-23. Results Significantly higher serum FGF-23 was found in diabetic patients with PAD compared with diabetic patients without PAD. Logistic regression analysis showed that duration of diabetes, triglycerides level, phosphorous level, glycated hemoglobin, and FGF-23 were independent predictors for PAD. Conclusion FGF-23 level was higher in type 2 diabetic patients with PAD, which highlights a possible implication of FGF-23 in the pathogenesis of PAD in type 2 diabetes.

Keywords

• diabetes
• fgf-23
• pad