FGF23-klotho axis as predictive factors of fractures in type 2 diabetics with early chronic kidney disease

Ribeiro, Ana Luisa; Mendes, Filipa; Carias, Eduarda; Rato, Fátima; Santos, Nélio; Neves, Pedro Leão; Silva, Ana Paula

Publication

FGF23-klotho axis as predictive factors of fractures in type 2 diabetics with early chronic kidney disease

2020Journal article

dc.contributor.author	Ribeiro, Ana Luisa
dc.contributor.author	Mendes, Filipa
dc.contributor.author	Carias, Eduarda
dc.contributor.author	Rato, Fátima
dc.contributor.author	Santos, Nélio
dc.contributor.author	Neves, Pedro Leão
dc.contributor.author	Silva, Ana Paula
dc.date.accessioned	2020-02-18T21:01:28Z
dc.date.available	2020-02-18T21:01:28Z
dc.date.issued	2020
dc.description.abstract	Background: The aim of our study was to evaluate the relevance of FGF23-klotho axis in the predisposition for bone fractures in type 2 diabetic patients with early chronic kidney disease. Methods: In a prospective study we included 126 type 2 diabetic patients with CKD stages 2-3 (from 2010 to 2017). We used descriptive statistics, ANOVA and chi-square test. Our population was divided into two groups according to the occurrence of a bone fracture event or not, and the groups were compared considering several biological and laboratorial parameters. We employed a multiple regression model to identify risk factors for bone fracture events and hazard ratios (HR) were calculated using a backward stepwise likelihood ratio (LR) Cox regression. Results: Patients with a fracture event displayed higher levels of FGF-23, Phosphorus, PTH, TNF-alpha, OxLDL, HOMA-IR, calcium x phosphorus product and ACR and lower levels of Osteocalcin, alpha-Klotho, 25(OH)D3 and eGFR compared with patients without a fracture event (p < 0.001). The number of patients with a fracture event was higher than expected within inclining CKD stages (chi 2, p = 0.06). The occurrence of fracture and the levels of TNF-alpha, klotho, 25(OH)D3 and OxLDL were found to predict patient entry into RRT (p < 0.05). Age, osteocalcin, alpha-Klotho and FGF-23 independently influenced the occurrence of bone fracture (p < 0.05). Conclusions: alpha-Klotho and FGF-23 levels may have a good clinical use as biomarkers to predict the occurrence of fracture events. (C) 2019 Elsevier Inc. All rights reserved.	pt_PT
dc.description.version	info:eu-repo/semantics/publishedVersion	pt_PT
dc.identifier.doi	https://doi.org/10.1016/j.jdiacomp.2019.107476	pt_PT
dc.identifier.issn	1056-8727
dc.identifier.uri	http://hdl.handle.net/10400.1/13530
dc.language.iso	eng	pt_PT
dc.peerreviewed	yes	pt_PT
dc.publisher	Elsevier	pt_PT
dc.rights.uri	http://creativecommons.org/licenses/by/4.0/	pt_PT
dc.subject	Bone fracture	pt_PT
dc.subject	Chronic kidney disease	pt_PT
dc.subject	Diabetes	pt_PT
dc.subject	FGF-23	pt_PT
dc.title	FGF23-klotho axis as predictive factors of fractures in type 2 diabetics with early chronic kidney disease	pt_PT
dc.type	journal article
dspace.entity.type	Publication
oaire.citation.issue	1	pt_PT
oaire.citation.startPage	107476	pt_PT
oaire.citation.title	Journal of Diabetes and its Complications	pt_PT
oaire.citation.volume	34	pt_PT
person.familyName	Ribeiro Vicente
person.familyName	Mendes
person.familyName	Neves
person.givenName	Ana Luisa
person.givenName	Filipa
person.givenName	Pedro Leão
person.identifier.ciencia-id	3313-C65E-A81B
person.identifier.ciencia-id	1014-3EA2-C680
person.identifier.orcid	0000-0003-1583-3729
person.identifier.orcid	0000-0002-0329-8805
person.identifier.orcid	0000-0002-8463-0768
person.identifier.scopus-author-id	55817764700
person.identifier.scopus-author-id	7003907170
rcaap.rights	openAccess	pt_PT
rcaap.type	article	pt_PT
relation.isAuthorOfPublication	040be637-9dca-4a9c-ad76-bae87d49ac82
relation.isAuthorOfPublication	871b65e7-2325-4468-a518-070543f80346
relation.isAuthorOfPublication	788c02e9-1087-4e30-8a34-5379261fc739
relation.isAuthorOfPublication.latestForDiscovery	788c02e9-1087-4e30-8a34-5379261fc739