Is FGF-23 an early indicator of atherosclerosis and cardiac dysfunction in patients with gestational diabetes?

Arch Endocrinol Metab. 2018 Oct;62(5):506-513. doi: 10.20945/2359-3997000000070.

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.

MeSH terms

  • Adult
  • Blood Glucose / analysis
  • Carotid Intima-Media Thickness
  • Case-Control Studies
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Coronary Artery Disease / blood*
  • Coronary Artery Disease / diagnostic imaging
  • Cross-Sectional Studies
  • Diabetes, Gestational / blood*
  • Echocardiography, Doppler / methods
  • Fasting
  • Female
  • Fibroblast Growth Factor-23
  • Fibroblast Growth Factors / blood*
  • Glucose Tolerance Test
  • Humans
  • Insulin Resistance
  • Pregnancy
  • Prospective Studies
  • Reference Values
  • Risk Factors
  • Triglycerides / blood
  • Ventricular Dysfunction, Left / blood*
  • Ventricular Dysfunction, Left / diagnostic imaging
  • Young Adult

Substances

  • Blood Glucose
  • Cholesterol, HDL
  • Cholesterol, LDL
  • FGF23 protein, human
  • Triglycerides
  • Fibroblast Growth Factors
  • Fibroblast Growth Factor-23