title: Associations between FGF21, osteonectin and bone turnover markers in type 2 diabetic patients with albuminuria.
abstract: OBJECTIVE
  We measured the levels of bone turnover markers (BTMs) in patients with early diabetic nephropathy from type 2 diabetes mellitus (T2DM), and investigated the associations of BTMs with adipokines, serum fibroblast growth factor-21 (FGF21) and osteonectin.
  
  
  METHODS
  We included 159 males and 300 females with T2DM in this cross-sectional study. Clinical characteristics, BTMs and adipokines levels were measured.
  
  
  RESULTS
  One-hundred and ninety-two (41.8%) patients presented with albuminuria. Patients with albuminuria had significantly higher levels of serum osteonectin (P<0.0001) and FGF21 (P=0.0125) than those with normoalbuminuria. Serum levels of P1NP were slightly lower among patients with albuminuria (P=0.031), but the difference disappeared after adjusting for FBG, PBG, and HbA1c. Serum FGF21 levels were independently and negatively related to eGFR (overall β=-0.161, P=0.001; albuminuria group β=-0.240, P=0.001) but not related to uACR. While Osteonectin was independently and positively related to uACR (overall β=0.209, P=0.001; albuminuria group β=0.170, P=0.021). The levels of serum FGF21 were independently inversely related with P1NP (overall β=-0.192, P<0.0001; albuminuria group β=-0.195, P=0.031).
  
  
  CONCLUSIONS
  Our results suggest that persistent hyperglycemia may inhibit bone formation. Both osteonectin and FGF21 were associated with early nephropathy in T2DM patients, albeit with different patterns.
authors.affiliation: Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan No.1, Dongcheng District, Beijing 100730, China.
authors.forename: Lingling
authors.initials: L
authors.lastname: Xu
authors.affiliation: Department of Endocrinology, Traditional Chinese Medicine Hospital of Muping District of Yantai City, Yantai, Shandong, China.
authors.forename: Meng
authors.initials: M
authors.lastname: Niu
authors.affiliation: Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China.
authors.forename: Weihong
authors.initials: W
authors.lastname: Yu
authors.affiliation: Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan No.1, Dongcheng District, Beijing 100730, China.
authors.forename: Weibo
authors.initials: W
authors.lastname: Xia
authors.affiliation: Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan No.1, Dongcheng District, Beijing 100730, China.
authors.forename: Fengying
authors.initials: F
authors.lastname: Gong
authors.affiliation: Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan No.1, Dongcheng District, Beijing 100730, China. Electronic address: wang_ou2010@126.com.
authors.forename: Ou
authors.initials: O
authors.lastname: Wang
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000209:etiology*; D015415:Biomarkers / Q000097:blood / Q000652:urine; D001862:Bone Resorption / Q000150:complications; D002681:China; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000628:therapy / Q000652:urine; D003928:Diabetic Nephropathies / Q000150:complications* / Q000503:physiopathology; D005260:Female; D005346:Fibroblast Growth Factors / Q000097:blood*; D005919:Glomerular Filtration Rate; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control; D007668:Kidney / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015676:Osteonectin / Q000097:blood*; D010024:Osteoporosis / Q000150:complications*; D051437:Renal Insufficiency / Q000150:complications* / Q000503:physiopathology; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D005346:Fibroblast Growth Factors; D006442:Glycated Hemoglobin; D015676:Osteonectin; C414620:fibroblast growth factor 21; C517652:hemoglobin A1c protein, human
keywords: Bone turnover marker; Diabetic nephropathy; Fibroblast growth factor-21; Osteonectin; Type 2 diabetes