Changes of serum fibroblast growth factor 23 (FGF23) and Klotho in diabetic kidney disease and their correlation with coronary artery calcification: a retrospective study

Abstract

Objective This study investigated the association among fibroblast growth factor 23 (FGF23), Klotho, and coronary artery calcification (CAC) in patients with diabetic kidney disease (DKD). Subjects and methods A total of 176 DKD patients and 160 age-and diabetes-matched controls were retrospectively analyzed. We measured serum FGF23 and Klotho levels by enzyme-linked immunosorbent assay and assessed CAC by CAC scoring. Correlation and receiver operating characteristic analyses were performed to evaluate the associations of these biomarkers with CAC and their ability to discriminate CAC. Results FGF23 levels were significantly higher and Klotho levels were lower in patients with DKD than in controls. FGF23 correlated negatively with estimated glomerular filtration rate and positively with the albumin-to-creatinine ratio and blood urea nitrogen, whereas Klotho correlated positively with estimated glomerular filtration rate and negatively with albumin-to-creatinine ratio and blood urea nitrogen. In patients with CAC, FGF23 levels were higher and Klotho levels were lower. Receiver operating characteristic analysis showed that both FGF23 and Klotho discriminated CAC, and FGF23 showed a higher area under curve than Klotho. Correlation analysis further confirmed the association of FGF23 and Klotho with CAC severity. Conclusion FGF23 and Klotho were associated with renal impairment and CAC in patients with DKD and may serve as potential biomarkers of renal and cardiovascular risk.