title: Altered serum levels of FGF-23 and magnesium are independent risk factors for an increased albumin-to-creatinine ratio in type 2 diabetics with chronic kidney disease.
abstract: OBJECTIVE
  To investigate the role of FGF-23 and magnesium in relation to the albumin-to-creatinine ratio in type 2 diabetics with chronic kidney disease (CKD) stages 2-4.
  
  
  METHODS
  In a cross-sectional study we included all eligible type 2 diabetic patients with CKD stages 2-4, followed in our outpatient Diabetic Kidney clinic. We used descriptive statistics, the Student'st-test, ANOVA and the chi-square tests. Our population was divided according to the UACR (G1 30-300 mg/g and G2≥300 mg/g), and compared these groups regarding several biological and laboratorial parameters. We employed a multiple regression model to identify risk factors of increased UACR.
  
  
  RESULTS
  The patients in G2 displayed a lower eGFR (p=0.0001) and, had lower levels of magnesium (p=0.004) as well as higher levels of FGF-23 (p=0.043) compared to patients in G1. FGF-23 (β=0.562, P=0.0001) and the magnesium (β=- 8.916, p=0.0001) were associated with increased UACR.
  
  
  CONCLUSIONS
  A dysregulation of mineral metabolism, reflected by altered levels of magnesium and FGF-23, correlates with an increased UACR in type 2 diabetic patients with CKD stages 2-4.
authors.affiliation: Nephrology, Centro Hospitalar do Algarve, Faro, Portugal; Department of Biomedical Sciences and Medicine, University of Algarve, Faro, Portugal. Electronic address: anapassionara@gmail.com.
authors.forename: Ana Paula
authors.initials: AP
authors.lastname: Silva
authors.affiliation: Nephrology, Centro Hospitalar do Algarve, Faro, Portugal.
authors.forename: Filipa
authors.initials: F
authors.lastname: Mendes
authors.affiliation: Nephrology, Centro Hospitalar do Algarve, Faro, Portugal.
authors.forename: André
authors.initials: A
authors.lastname: Fragoso
authors.affiliation: Nephrology, Centro Hospitalar do Algarve, Faro, Portugal.
authors.forename: Teresa
authors.initials: T
authors.lastname: Jeronimo
authors.affiliation: Nephrology, Centro Hospitalar do Algarve, Faro, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Pimentel
authors.affiliation: Fresenius Medical Care Deutschland GmbH, Bad Homburg vor der Höhe, Germany.
authors.forename: Kristina
authors.initials: K
authors.lastname: Gundlach
authors.affiliation: Fresenius Medical Care Deutschland GmbH, Bad Homburg vor der Höhe, Germany.
authors.forename: Janine
authors.initials: J
authors.lastname: Büchel
authors.affiliation: Pathology Clinic, Centro Hospitalar do Algarve, Faro, Portugal.
authors.forename: Nélio
authors.initials: N
authors.lastname: Santos
authors.affiliation: Nephrology, Centro Hospitalar do Algarve, Faro, Portugal; Department of Biomedical Sciences and Medicine, University of Algarve, Faro, Portugal.
authors.forename: Pedro Leão
authors.initials: PL
authors.lastname: Neves
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000418:Albumins / Q000032:analysis* / Q000378:metabolism; D000419:Albuminuria / Q000097:blood / Q000150:complications; D003404:Creatinine / Q000097:blood*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications*; D003928:Diabetic Nephropathies / Q000097:blood*; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood*; D006801:Humans; D008274:Magnesium / Q000097:blood*; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000150:complications; D012307:Risk Factors
chemical_list: D000418:Albumins; C000717427:FGF23 protein, human; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; D003404:Creatinine; D008274:Magnesium
keywords: Chronic kidney disease; Diabetes; FGF-23; Magnesium; Proteinuria