Is FGF-23 an Early Indicator of Atherosclerosis and Cardiac Dysfunction in Patients with Gestational Diabetes?

Overview

Journal Arch Endocrinol Metab

Specialty Endocrinology

Date 2018 Nov 22

PMID 30462803

Citations 7

Authors

Dilek Tuzun

Ayten Oguz

Muhammet Naci Aydin

Ergul Belge Kurutas

Onder Ercan

Murat Sahin

Velid Unsal

Imran Ceren

Ahmet Akcay

Kamile Gul

Affiliations

Soon will be listed here.

Abstract

Objective: Fibroblast growth factor 23 (FGF-23) is a phosphorus-regulating hormone and plays a role in the pathogenesis of myocardial hypertrophy. The aim of this study was to evaluate the association of FGF-23 levels with echocardiographic parameters and insulin resistance (IR) in patients with gestational diabetes.

Subjects And Methods: Fifty-four pregnant patients with gestational diabetes mellitus (GDM) (age, 31.12 ± 5.72 years) and 33 healthy pregnant women (age, 29.51 ± 4.92 years) were involved in the study. Fasting insulin, fasting plasma glucose (FPG), lipid profile, oral glucose tolerance test (OGTT), FGF23, echocardiographic parameters, and carotid artery intima-media thickness (CIMT) were evaluated in the two groups.

Results: The two groups were not significantly different in age, sex, body mass index, lipid profile, or blood pressure. Insulin, homeostatic model assessment-insulin resistance (HOMA-IR), FGF-23 levels, CIMT, left ventricular (LV) mass, LV mass index and myocardial performance index (MPI) were significantly higher in the GDM group. HOMA-IR was positively correlated with FGF-23, and insulin was positively correlated with FGF-23. Additionally, FGF-23 was positively correlated with CIMT, LV mass index, and MPI.

Conclusion: Our findings suggest that monitoring serum FGF-23 may be useful as a non-invasive indicator of subclinical atherosclerosis in patients with GDM.

Citing Articles

Relationships of serum FGF23 and α-klotho with atherosclerosis in patients with type 2 diabetes mellitus.

Bi J, Zheng M, Li K, Sun S, Zhang Z, Yan N Cardiovasc Diabetol. 2024; 23(1):128.

PMID: 38622690 PMC: 11020347. DOI: 10.1186/s12933-024-02205-2.

The Role of the FGF19 Family in the Pathogenesis of Gestational Diabetes: A Narrative Review.

Sadowska A, Poniedzialek-Czajkowska E, Mierzynski R Int J Mol Sci. 2023; 24(24).

PMID: 38139126 PMC: 10743406. DOI: 10.3390/ijms242417298.

The effect of gestational diabetes mellitus on carotid artery intima-media thickness in and after pregnancy: a systematic review and meta-analysis.

Sonaglioni A, Piergallini E, Naselli A, Nicolosi G, Ferrulli A, Bianchi S Acta Diabetol. 2023; 61(2):139-149.

PMID: 37936027 DOI: 10.1007/s00592-023-02206-9.

New developments in the biology of fibroblast growth factors.

Ornitz D, Itoh N WIREs Mech Dis. 2022; 14(4):e1549.

PMID: 35142107 PMC: 10115509. DOI: 10.1002/wsbm.1549.

Hyperphosphatemia and Cardiovascular Disease.

Zhou C, Shi Z, Ouyang N, Ruan X Front Cell Dev Biol. 2021; 9:644363.

PMID: 33748139 PMC: 7970112. DOI: 10.3389/fcell.2021.644363.

References

Orem C, Kucukosmanoglu M, Hacihasanoglu A, Yilmaz R, Kasap H, Erdogan T . Association of Doppler-derived myocardial performance index with albuminuria in patients with diabetes. J Am Soc Echocardiogr. 2004; 17(11):1185-90. DOI: 10.1016/j.echo.2004.07.006. View

Isakova T, Xie H, Yang W, Xie D, Anderson A, Scialla J . Fibroblast growth factor 23 and risks of mortality and end-stage renal disease in patients with chronic kidney disease. JAMA. 2011; 305(23):2432-9. PMC: 3124770. DOI: 10.1001/jama.2011.826. View

Mishra R, Kizer J, Palmieri V, Roman M, Galloway J, Fabsitz R . Utility of the myocardial performance index in a population with high prevalences of obesity, diabetes, and hypertension: the strong heart study. Echocardiography. 2007; 24(4):340-7. DOI: 10.1111/j.1540-8175.2007.00415.x. View

Tei C, Ling L, Hodge D, Bailey K, Oh J, Rodeheffer R . New index of combined systolic and diastolic myocardial performance: a simple and reproducible measure of cardiac function--a study in normals and dilated cardiomyopathy. J Cardiol. 1995; 26(6):357-66. View

Catalano P, Kirwan J, Haugel-De Mouzon S, King J . Gestational diabetes and insulin resistance: role in short- and long-term implications for mother and fetus. J Nutr. 2003; 133(5 Suppl 2):1674S-1683S. DOI: 10.1093/jn/133.5.1674S. View

Keser N, Yildiz S, Kurtog N, Dindar I . Modified TEI index: a promising parameter in essential hypertension?. Echocardiography. 2005; 22(4):296-304. DOI: 10.1111/j.1540-8175.2005.03141.x. View

Gungor O, Kismali E, Sisman A, Kircelli F, Carrero J, Tatar E . The relationships between serum sTWEAK, FGF-23 levels, and carotid atherosclerosis in renal transplant patients. Ren Fail. 2012; 35(1):77-81. DOI: 10.3109/0886022X.2012.734890. View

Garland J, Holden R, Ross R, Adams M, Nolan R, Hopman W . Insulin resistance is associated with Fibroblast Growth Factor-23 in stage 3-5 chronic kidney disease patients. J Diabetes Complications. 2013; 28(1):61-5. DOI: 10.1016/j.jdiacomp.2013.09.004. View

Baz B, Riveline J, Gautier J . ENDOCRINOLOGY OF PREGNANCY: Gestational diabetes mellitus: definition, aetiological and clinical aspects. Eur J Endocrinol. 2015; 174(2):R43-51. DOI: 10.1530/EJE-15-0378. View

10.

Turfan M, Akyel A, Bolayir H, Vatankulu M, Akturk M, Yetkin I . Correlation of the myocardial performance index with plasma B-type natriuretic peptide levels in type 2 diabetes mellitus and impaired glucose tolerance. Kardiol Pol. 2012; 70(6):556-62. View

11.

Matthews D, Hosker J, Rudenski A, Naylor B, Treacher D, Turner R . Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985; 28(7):412-9. DOI: 10.1007/BF00280883. View

12.

Evrengul H, Dursunoglu D, Kaftan A, Kilicaslan F, Tanriverdi H, Kilic M . Relation of insulin resistance and left ventricular function and structure in non-diabetic patients with essential hypertension. Acta Cardiol. 2005; 60(2):191-8. DOI: 10.2143/AC.60.2.2005031. View

13.

Knock G, McCarthy A, Lowy C, Poston L . Association of gestational diabetes with abnormal maternal vascular endothelial function. Br J Obstet Gynaecol. 1997; 104(2):229-34. DOI: 10.1111/j.1471-0528.1997.tb11051.x. View

14.

Munoz-Hoyos A, Molina-Carballo A, Acuna-Castroviejo D . Melatonin concentration in the umbilical artery and vein in human preterm and term neonates and neonates with acute fetal distress. J Pineal Res. 1992; 13(4):184-91. DOI: 10.1111/j.1600-079x.1992.tb00074.x. View

15.

Ernande L, Bergerot C, Girerd N, Thibault H, Davidsen E, Gautier Pignon-Blanc P . Longitudinal myocardial strain alteration is associated with left ventricular remodeling in asymptomatic patients with type 2 diabetes mellitus. J Am Soc Echocardiogr. 2014; 27(5):479-88. DOI: 10.1016/j.echo.2014.01.001. View

16.

Wahl P, Xie H, Scialla J, Anderson C, Bellovich K, Brecklin C . Earlier onset and greater severity of disordered mineral metabolism in diabetic patients with chronic kidney disease. Diabetes Care. 2012; 35(5):994-1001. PMC: 3329844. DOI: 10.2337/dc11-2235. View

17.

Hanks L, Casazza K, Judd S, Jenny N, Gutierrez O . Associations of fibroblast growth factor-23 with markers of inflammation, insulin resistance and obesity in adults. PLoS One. 2015; 10(3):e0122885. PMC: 4374938. DOI: 10.1371/journal.pone.0122885. View

18.

Chirayath H, Wareing M, Taggart M, Baker P . Endothelial dysfunction in myometrial arteries of women with gestational diabetes. Diabetes Res Clin Pract. 2010; 89(2):134-40. DOI: 10.1016/j.diabres.2010.03.022. View

19.

Gosse P . Left ventricular hypertrophy as a predictor of cardiovascular risk. J Hypertens Suppl. 2005; 23(1):S27-33. DOI: 10.1097/01.hjh.0000165625.79933.9a. View

20.

Karatzis E, Giannakopoulou A, Papadakis J, Karazachos A, Nearchou N . Myocardial performance index (Tei index): evaluating its application to myocardial infarction. Hellenic J Cardiol. 2009; 50(1):60-5. View