title: Fibroblast growth factor-23 but not sKlotho levels are related to diastolic dysfunction in type 1 diabetic patients with early diabetic nephropathy.
abstract: OBJECTIVE
  To investigate the soluble Klotho (sKlotho) and fibroblast growth factor-23 (FGF-23) levels and echocardiographic findings in type 1 diabetic patients with no or early diabetic nephropathy.
  
  
  METHODS
  A total of 147 subjects (mean age 34.1 ± 9.2 years, 55.8 % were females) including type 1 diabetic patients with glomerular filtration rate (GFR) >60 ml/min (n = 71, mean age 34.3 ± 9.5 years, 54.9 % were females) and healthy controls (n = 76, mean age 33.9 ± 9.1 years, 56.6 % were females) were included in this study. Data on demographic characteristics, blood biochemistry, urinalysis, diabetes-related complications and echocardiography were recorded. Serum levels for sKlotho and FGF-23 were determined by ELISA method.
  
  
  RESULTS
  Patient and control groups were similar in terms of mean sKlotho (509.2 ± 183.5 and 547.6 ± 424.0 pg/ml, respectively) and FGF-23 (76.2 ± 15.6 and 77.2 ± 15.1 pg/ml, respectively) levels as well as echocardiographic findings. No significant correlation of sKlotho (pg/ml) and FGF-23 (pg/ml) levels with cardiac parameters was noted among diabetic patients. In subgroup analysis, the correlations between FGF-23 levels and isovolumic relaxation time (ms) and early diastolic velocity at medial/septal annulus (E'med) (m/s) were significant only in patients with early diabetic nephropathy (DN) but not in non-DN patients. No significant association of sKlotho levels with echocardiographic findings was noted.
  
  
  CONCLUSIONS
  Our findings in young adult type 1 diabetic patients with GFR >60 ml/min versus healthy controls revealed no difference between groups in terms of sKlotho and FGF-23 levels and echocardiographic findings, while a significant correlation of FGF-23 (pg/ml) levels and diastolic dysfunction was noted only in patients with DN.
authors.affiliation: Department of Family Physicians, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey. burcutdogan@hotmail.com.
authors.forename: Burcu
authors.initials: B
authors.lastname: Dogan
authors.affiliation: Department of Nephrology, Marmara University Pendik Hospital, Istanbul, Turkey.
authors.forename: Izzet Hakki
authors.initials: IH
authors.lastname: Arikan
authors.affiliation: Department of Nephrology, Marmara University Pendik Hospital, Istanbul, Turkey.
authors.forename: Derya
authors.initials: D
authors.lastname: Guler
authors.affiliation: Department of Cardiology, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey.
authors.forename: Nursen
authors.initials: N
authors.lastname: Keles
authors.affiliation: Department of Clinical Chemistry, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey.
authors.forename: Banu
authors.initials: B
authors.lastname: Isbilen
authors.affiliation: Department of Clinical Chemistry, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ferruh
authors.initials: F
authors.lastname: Isman
authors.affiliation: Department of Internal Medicine, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey.
authors.forename: Aytekin
authors.initials: A
authors.lastname: Oguz
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000378:metabolism; D003928:Diabetic Nephropathies / Q000150:complications* / Q000378:metabolism; D003971:Diastole; D018450:Disease Progression; D004452:Echocardiography; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000378:metabolism*; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D000090265:Klotho Proteins; D008297:Male; D008565:Membrane Proteins / Q000378:metabolism*; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000378:metabolism* / Q000503:physiopathology
chemical_list: D015415:Biomarkers; C000717427:FGF23 protein, human; C538995:KLB protein, human; D008565:Membrane Proteins; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; D000090265:Klotho Proteins
keywords: Cardiac function; Diabetic nephropathy; FGF-23; Type 1 diabetes mellitus; sKlotho