Impact of Fibroblast Growth Factor-23 on Peripheral Arterial Disease in Type 2 Diabetes Mellitus: A Comparative Cross-Sectional Pilot Study

ABSTRACT

Purpose: To evaluate whether fibroblast growth factor-23 (FGF-23) has a common role in the pathogenesis of peripheral arterial disease (PAD) and chronic kidney disease (CKD) in type-2 diabetes mellitus (DM).
Material and Method: Twenty-one patients with diabetic nephropathy composed the diabetic nephropathy (DM-NP) group and 20 subjects with DM but without NP constituted the DM group. The control group was comprised of 10 age- and gender-matched non-diabetic individuals with CKD.
Results: FGF-23 levels were similar in DM-NP and CKD groups (p=0.5). Both groups had higher FGF-23 levels compared to DM group (p<0.001 and p=0.007). PAD was more common in DM than in CKD (p=0.03). In all cases involving DM (e.g., both the DM-NP and DM-groups), FGF-23 levels did not vary with arterial wall changes recorded via Doppler ultrasonography (p=0.5).
Discussion: NP and PAD may be independent complications of DM. In DM, FGF-23 may be a marker of NP but not of PAD.