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Fibroblast growth factor-23 but not sKlotho levels are related to diastolic dysfunction in type 1 diabetic patients with early diabetic nephropathy

International Urology and Nephrology volume 48, pages 399–407 (2016)Cite this article

Abstract

Purpose

To investigate the soluble Klotho (sKlotho) and fibroblast growth factor-23 (FGF-23) levels and echocardiographic findings in type 1 diabetic patients with no or early diabetic nephropathy.

Methods

A total of 147 subjects (mean age 34.1 ± 9.2 years, 55.8 % were females) including type 1 diabetic patients with glomerular filtration rate (GFR) >60 ml/min (n = 71, mean age 34.3 ± 9.5 years, 54.9 % were females) and healthy controls (n = 76, mean age 33.9 ± 9.1 years, 56.6 % were females) were included in this study. Data on demographic characteristics, blood biochemistry, urinalysis, diabetes-related complications and echocardiography were recorded. Serum levels for sKlotho and FGF-23 were determined by ELISA method.

Results

Patient and control groups were similar in terms of mean sKlotho (509.2 ± 183.5 and 547.6 ± 424.0 pg/ml, respectively) and FGF-23 (76.2 ± 15.6 and 77.2 ± 15.1 pg/ml, respectively) levels as well as echocardiographic findings. No significant correlation of sKlotho (pg/ml) and FGF-23 (pg/ml) levels with cardiac parameters was noted among diabetic patients. In subgroup analysis, the correlations between FGF-23 levels and isovolumic relaxation time (ms) and early diastolic velocity at medial/septal annulus (E’med) (m/s) were significant only in patients with early diabetic nephropathy (DN) but not in non-DN patients. No significant association of sKlotho levels with echocardiographic findings was noted.

Conclusions

Our findings in young adult type 1 diabetic patients with GFR >60 ml/min versus healthy controls revealed no difference between groups in terms of sKlotho and FGF-23 levels and echocardiographic findings, while a significant correlation of FGF-23 (pg/ml) levels and diastolic dysfunction was noted only in patients with DN.

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Acknowledgments

The study is granted by Sanofi-Aventis, Turkey. We thank Cagla Ayhan, MD, and Prof. Sule Oktay, MD, Ph.D., from KAPPA Consultancy Training Research Ltd., Istanbul, who provided editorial support funded by Sanofi-Aventis, Turkey.

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Authors and Affiliations

  1. Department of Family Physicians, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey

    Burcu Dogan

  2. Department of Nephrology, Marmara University Pendik Hospital, Istanbul, Turkey

    Izzet Hakki Arikan & Derya Guler

  3. Department of Cardiology, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey

    Nursen Keles

  4. Department of Clinical Chemistry, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey

    Banu Isbilen & Ferruh Isman

  5. Department of Internal Medicine, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey

    Aytekin Oguz

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  1. Burcu Dogan
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Dogan, B., Arikan, I.H., Guler, D. et al. Fibroblast growth factor-23 but not sKlotho levels are related to diastolic dysfunction in type 1 diabetic patients with early diabetic nephropathy. Int Urol Nephrol 48, 399–407 (2016). https://doi.org/10.1007/s11255-015-1190-y

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  • DOI: https://doi.org/10.1007/s11255-015-1190-y

Keywords

  • Type 1 diabetes mellitus
  • sKlotho
  • FGF-23
  • Cardiac function
  • Diabetic nephropathy