The role of Klotho and FGF23 in cardiovascular outcomes of diabetic patients with chronic limb threatening ischemia: a prospective study.

Autor: Biscetti F; Cardiovascular Internal Medicine, Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy. f.biscetti@gmail.com., Rando MM; Cardiovascular Internal Medicine, Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy., Cecchini AL; Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168, Rome, Italy., Nicolazzi MA; Cardiovascular Internal Medicine, Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy., Rossini E; Cardiovascular Internal Medicine, Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy., Angelini F; Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168, Rome, Italy., Iezzi R; Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168, Rome, Italy.; Radiology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy., Eraso LH; Division of Vascular and Endovascular Surgery, Thomas Jefferson University, Philadelphia, PA, USA., Dimuzio PJ; Division of Vascular and Endovascular Surgery, Thomas Jefferson University, Philadelphia, PA, USA., Pitocco D; Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168, Rome, Italy.; Diabetology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy., Gasbarrini A; Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168, Rome, Italy.; Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy., Massetti M; Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168, Rome, Italy.; Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy., Flex A; Cardiovascular Internal Medicine, Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy.; Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168, Rome, Italy.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2023 Apr 15; Vol. 13 (1), pp. 6150. Date of Electronic Publication: 2023 Apr 15.
DOI: 10.1038/s41598-023-33190-3
Abstrakt: Cardiovascular complications after lower extremity revascularization (LER) are common in diabetic patients with peripheral arterial disease (PAD) and chronic limb threatening ischemia (CLTI). The Klotho-fibroblast growth factor 23 (FGF23) axis is associated with endothelial injury and cardiovascular risk. We aimed to analyze the relationship between Klotho and FGF23 serum levels and the incidence of major adverse cardiovascular events (MACE) and major adverse limb events (MALE) after LER in diabetic patients with PAD and CLTI. Baseline levels of Klotho and FGF23, and their association with subsequent incidence of MACE and MALE were analyzed in a prospective, non-randomized study in a population of diabetic patients with PAD and CLTI requiring LER. A total of 220 patients were followed for 12 months after LER. Sixty-three MACE and 122 MALE were recorded during follow-up period. Baseline lower Klotho serum levels (295.3 ± 151.3 pg/mL vs. 446.4 ± 171.7 pg/mL, p < 0.01), whereas increased serum levels FGF23 (75.0 ± 11.8 pg/mL vs. 53.2 ± 15.4 pg/mL, p < 0.01) were significantly associated with the development of MACE. Receiver operating characteristic (ROC) analysis confirmed the predictive power of Klotho and FGF23 baseline levels. Furthermore, decreased Klotho levels were associated with the occurrence of MALE after LER (329.1 ± 136.8 pg/mL vs 495.4 ± 183.9 pg/mL, p < 0.01). We found that Klotho and FGF23 baseline levels are a potential biomarker for increased cardiovascular risk after LER in diabetic patients with PAD and CLTI.
(© 2023. The Author(s).)
Databáze: MEDLINE
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