Insulin resistance is associated with Fibroblast Growth Factor-23 in stage 3–5 chronic kidney disease patients
| Autor: | Robert L. Nolan, Jocelyn S. Garland, Rachel M. Holden, Michael A. Adams, A. Ross Morton, Wilma M. Hopman, Robert Ross |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Fibroblast growth factor 23 medicine.medical_specialty Endocrinology Diabetes and Metabolism Renal function Parathyroid hormone Coronary Artery Disease Phosphates Endocrinology Insulin resistance Interquartile range Diabetes mellitus Internal medicine Internal Medicine Humans Medicine Renal Insufficiency Chronic Risk factor Aged Aged 80 and over Metabolic Syndrome business.industry Calcinosis Middle Aged medicine.disease Fibroblast Growth Factors Fibroblast Growth Factor-23 Cross-Sectional Studies Disease Progression Female Insulin Resistance business Glomerular Filtration Rate Kidney disease |
| Zdroj: | Journal of Diabetes and its Complications. 28:61-65 |
| ISSN: | 1056-8727 |
| Popis: | Aim To determine the associations between insulin resistance, fibroblast growth factor 23 (FGF-23), and coronary artery calcification (CAC) in chronic kidney disease (CKD) patients. Introduction FGF-23 is associated with atherosclerosis and cardiovascular disease, but its association with insulin resistance in CKD has not been explored. Subjects Cross sectional study of 72 stage 3–5 CKD patients receiving care in Ontario, Canada. Materials and Methods Insulin resistance was measured by the homeostasis model assessment of insulin resistance (HOMA-IR), FGF-23 was measured by carboxyl terminal enzyme linked immunoassay (ctFGF-23) and CAC was measured by multi-slice computed tomography. Results Median HOMA-IR was 2.19 μU/ml (interquartile range 1.19 to 3.94). Patients with HOMA-IR > 2.2 had greater ctFGF-23 (179.7 vs 109.6; P = 0.03), and 40% higher log CAC scores (2.09 ± 0.87 vs 1.58 ± 1.26; P = 0.049). Multivariable linear regression adjusted for 1,25 dihydroxyvitamin D, kidney function, and parathyroid hormone revealed insulin resistance was a risk factor for greater log ctFGF-23 levels (log HOMA IR β = 0.37; 95% confidence interval 0.14 to 0.59; P = 0.002). Conclusions Insulin resistant CKD patients demonstrated higher FGF-23 levels, and increased CAC, while PO4 levels remained normal, suggesting a potential link between insulin resistance and PO4 homeostasis in CKD. |
| Databáze: | OpenAIRE |
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