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Plasmatic Klotho and FGF23 Levels as Biomarkers of CKD-Associated Cardiac Disease in Type 2 Diabetic Patients

Background: Research over the past decade has focused on the role of Klotho as a cardio protective agent that prevents the effects of aging on the heart and reduces the burden of cardiovascular disease CVD. The role of the interaction between fibroblast growth factor 23-(FGF-23)/Klotho in Klotho-med...

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Autores principales: Silva, Ana Paula, Mendes, Filipa, Carias, Eduarda, Gonçalves, Rui Baptista, Fragoso, André, Dias, Carolina, Tavares, Nelson, Café, Hugo Mendonça, Santos, Nélio, Rato, Fátima, Leão Neves, Pedro, Almeida, Edgar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6480092/
https://www.ncbi.nlm.nih.gov/pubmed/30934737
http://dx.doi.org/10.3390/ijms20071536
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author Silva, Ana Paula
Mendes, Filipa
Carias, Eduarda
Gonçalves, Rui Baptista
Fragoso, André
Dias, Carolina
Tavares, Nelson
Café, Hugo Mendonça
Santos, Nélio
Rato, Fátima
Leão Neves, Pedro
Almeida, Edgar
author_facet Silva, Ana Paula
Mendes, Filipa
Carias, Eduarda
Gonçalves, Rui Baptista
Fragoso, André
Dias, Carolina
Tavares, Nelson
Café, Hugo Mendonça
Santos, Nélio
Rato, Fátima
Leão Neves, Pedro
Almeida, Edgar
author_sort Silva, Ana Paula
collection PubMed
description Background: Research over the past decade has focused on the role of Klotho as a cardio protective agent that prevents the effects of aging on the heart and reduces the burden of cardiovascular disease CVD. The role of the interaction between fibroblast growth factor 23-(FGF-23)/Klotho in Klotho-mediated actions is still under debate. The main objective was to ascertain the potential use of plasmatic Klotho and FGF23 as markers for CKD-associated cardiac disease and mortality. Methods: This was a prospective analysis conducted in an outpatient diabetic nephropathy clinic, enrolling 107 diabetic patients with stage 2–3 CKD. Patients were divided into three groups according to their left ventricular mass index and relative wall thickness. Results: Multinomial regression analysis demonstrated that low Klotho and higher FGF-23 levels were linked to a greater risk of concentric hypertrophy. In the generalized linear model (GLM), Klotho, FGF-23 and cardiac geometry groups were statistically significant as independent variables of cardiovascular hospitalization (p = 0.007). According to the Cox regression model, fatal cardiovascular events were associated with the following cardiac geometric classifications; eccentric hypertrophy (p = 0.050); concentric hypertrophy (p = 0.041), and serum phosphate ≥ 3.6 mg/dL (p = 0.025), FGF-23 ≥ 168 (p = 0.0149), α-klotho < 313 (p = 0.044). Conclusions: In our population, Klotho and FGF23 are associated with cardiovascular risk in the early stages of CKD.
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spelling pubmed-64800922019-04-29 Plasmatic Klotho and FGF23 Levels as Biomarkers of CKD-Associated Cardiac Disease in Type 2 Diabetic Patients Silva, Ana Paula Mendes, Filipa Carias, Eduarda Gonçalves, Rui Baptista Fragoso, André Dias, Carolina Tavares, Nelson Café, Hugo Mendonça Santos, Nélio Rato, Fátima Leão Neves, Pedro Almeida, Edgar Int J Mol Sci Article Background: Research over the past decade has focused on the role of Klotho as a cardio protective agent that prevents the effects of aging on the heart and reduces the burden of cardiovascular disease CVD. The role of the interaction between fibroblast growth factor 23-(FGF-23)/Klotho in Klotho-mediated actions is still under debate. The main objective was to ascertain the potential use of plasmatic Klotho and FGF23 as markers for CKD-associated cardiac disease and mortality. Methods: This was a prospective analysis conducted in an outpatient diabetic nephropathy clinic, enrolling 107 diabetic patients with stage 2–3 CKD. Patients were divided into three groups according to their left ventricular mass index and relative wall thickness. Results: Multinomial regression analysis demonstrated that low Klotho and higher FGF-23 levels were linked to a greater risk of concentric hypertrophy. In the generalized linear model (GLM), Klotho, FGF-23 and cardiac geometry groups were statistically significant as independent variables of cardiovascular hospitalization (p = 0.007). According to the Cox regression model, fatal cardiovascular events were associated with the following cardiac geometric classifications; eccentric hypertrophy (p = 0.050); concentric hypertrophy (p = 0.041), and serum phosphate ≥ 3.6 mg/dL (p = 0.025), FGF-23 ≥ 168 (p = 0.0149), α-klotho < 313 (p = 0.044). Conclusions: In our population, Klotho and FGF23 are associated with cardiovascular risk in the early stages of CKD. MDPI 2019-03-27 /pmc/articles/PMC6480092/ /pubmed/30934737 http://dx.doi.org/10.3390/ijms20071536 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Silva, Ana Paula
Mendes, Filipa
Carias, Eduarda
Gonçalves, Rui Baptista
Fragoso, André
Dias, Carolina
Tavares, Nelson
Café, Hugo Mendonça
Santos, Nélio
Rato, Fátima
Leão Neves, Pedro
Almeida, Edgar
Plasmatic Klotho and FGF23 Levels as Biomarkers of CKD-Associated Cardiac Disease in Type 2 Diabetic Patients
title Plasmatic Klotho and FGF23 Levels as Biomarkers of CKD-Associated Cardiac Disease in Type 2 Diabetic Patients
title_full Plasmatic Klotho and FGF23 Levels as Biomarkers of CKD-Associated Cardiac Disease in Type 2 Diabetic Patients
title_fullStr Plasmatic Klotho and FGF23 Levels as Biomarkers of CKD-Associated Cardiac Disease in Type 2 Diabetic Patients
title_full_unstemmed Plasmatic Klotho and FGF23 Levels as Biomarkers of CKD-Associated Cardiac Disease in Type 2 Diabetic Patients
title_short Plasmatic Klotho and FGF23 Levels as Biomarkers of CKD-Associated Cardiac Disease in Type 2 Diabetic Patients
title_sort plasmatic klotho and fgf23 levels as biomarkers of ckd-associated cardiac disease in type 2 diabetic patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6480092/
https://www.ncbi.nlm.nih.gov/pubmed/30934737
http://dx.doi.org/10.3390/ijms20071536
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