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Circulating fibroblast growth factor-23 plasma levels predict adverse cardiovascular outcomes in patients with diabetes mellitus with coronary artery disease
- Source :
- Diabetes/Metabolism Research and Reviews. 32:685-693
- Publication Year :
- 2016
- Publisher :
- Wiley, 2016.
-
Abstract
- BACKGROUND Abnormalities of fibroblast growth factor-23 (FGF-23) plasma levels predict adverse outcomes in patients with coronary artery disease. However, FGF-23 has a different behaviour in the presence of type 2 diabetes mellitus (T2D). We explored whether the presence of T2D affects the predictive power of FGF-23. METHODS In 704 patients with stable coronary artery disease, FGF-23, calcidiol, parathormone (PTH) and phosphate plasma levels were prospectively assessed. The primary outcome was the development of acute ischemic events (acute coronary syndrome, stroke or transient ischemic attack), heart failure or death. RESULTS One hundred seventy-three (24.6%) patients had T2D, without differences in age, sex or estimated glomerular filtration rate as compared with non-diabetic patients. Serum PTH was lower and phosphate higher in T2D than in non-diabetic patients, without differences in FGF-23 or calcidiol levels. During follow-up (2.15 ± 0.99 years), 26 (15.2%) T2D and 51 (9.6%) non-diabetic patients developed the outcome (p = 0.048). T2D patients who developed the outcome had higher FGF-23 [112.0 (59.9, 167.6) vs 68.9 (54.2, 93.0) RU/mL; p = 0.002], PTH [71.3 (47.3, 106.6) vs 51.9 (40.8, 66.2) pg/mL; p = 0.004) and phosphate (3.53 ± 0.71 vs 3.25 ± 0.50 mg/dL; p = 0.017) levels than T2D subjects who remained stable. These differences were not significant in non-diabetic patients. By multivariable Cox proportional hazard model, FGF-23 predicted independently the outcome in T2D patients [hazard ratio = 1.277; 95% CI (1.132, 1.442)] but not in those without T2D. CONCLUSIONS FGF-23 plasma levels predict adverse cardiovascular outcomes in coronary artery disease patients who have T2D but not in those without T2D. This finding should be confirmed in larger studies. Copyright © 2016 John Wiley & Sons, Ltd.
- Subjects :
- Fibroblast growth factor 23
medicine.medical_specialty
Acute coronary syndrome
endocrine system diseases
Proportional hazards model
business.industry
Endocrinology, Diabetes and Metabolism
nutritional and metabolic diseases
Renal function
030204 cardiovascular system & hematology
medicine.disease
Coronary artery disease
03 medical and health sciences
0302 clinical medicine
Endocrinology
Heart failure
Internal medicine
Diabetes mellitus
Internal Medicine
medicine
Cardiology
030212 general & internal medicine
business
Stroke
Subjects
Details
- ISSN :
- 15207552
- Volume :
- 32
- Database :
- OpenAIRE
- Journal :
- Diabetes/Metabolism Research and Reviews
- Accession number :
- edsair.doi...........54ddc79779b42c5d71407ecd82e7c0a8