成纤维细胞生长因子-23（FGF-23）是否为妊娠期糖尿病患者动脉粥样硬化和心脏功能障碍的早期指标？
Is FGF-23 an early indicator of atherosclerosis and cardiac dysfunction in patients with gestational diabetes?
作者信息
Tuzun Dilek, Oguz Ayten, Aydin Muhammet Naci, Kurutas Ergul Belge, Ercan Onder, Sahin Murat, Ünsal Velid, Ceren Imran, Akçay Ahmet, Gul Kamile
机构信息
Kahramanmaras Sutcu Imam University, Faculty of Medicine, Department of Endocrinology and Metabolism, Kahramanmaras, Turkey.
Kahramanmaras Sutcu Imam University, Faculty of Medicine, Department of Cardiology, Kahramanmaras, Turkey.
出版信息
Arch Endocrinol Metab. 2018 Oct;62(5):506-513. doi: 10.20945/2359-3997000000070.
OBJECTIVE
Fibroblast growth factor 23 (FGF-23) is a phosphorus-regulating hormone and plays a role in the pathogenesis of myocardial hypertrophy. The aim of this study was to evaluate the association of FGF-23 levels with echocardiographic parameters and insulin resistance (IR) in patients with gestational diabetes.
SUBJECTS AND METHODS
Fifty-four pregnant patients with gestational diabetes mellitus (GDM) (age, 31.12 ± 5.72 years) and 33 healthy pregnant women (age, 29.51 ± 4.92 years) were involved in the study. Fasting insulin, fasting plasma glucose (FPG), lipid profile, oral glucose tolerance test (OGTT), FGF23, echocardiographic parameters, and carotid artery intima-media thickness (CIMT) were evaluated in the two groups.
RESULTS
The two groups were not significantly different in age, sex, body mass index, lipid profile, or blood pressure. Insulin, homeostatic model assessment-insulin resistance (HOMA-IR), FGF-23 levels, CIMT, left ventricular (LV) mass, LV mass index and myocardial performance index (MPI) were significantly higher in the GDM group. HOMA-IR was positively correlated with FGF-23, and insulin was positively correlated with FGF-23. Additionally, FGF-23 was positively correlated with CIMT, LV mass index, and MPI.
CONCLUSION
Our findings suggest that monitoring serum FGF-23 may be useful as a non-invasive indicator of subclinical atherosclerosis in patients with GDM.
目的
成纤维细胞生长因子23（FGF - 23）是一种磷调节激素，在心肌肥厚的发病机制中起作用。本研究的目的是评估妊娠糖尿病患者中FGF - 23水平与超声心动图参数及胰岛素抵抗（IR）之间的关联。
对象与方法
本研究纳入了54例妊娠糖尿病（GDM）孕妇（年龄31.12±5.72岁）和33例健康孕妇（年龄29.51±4.92岁）。对两组患者进行空腹胰岛素、空腹血糖（FPG）、血脂谱、口服葡萄糖耐量试验（OGTT）、FGF23、超声心动图参数及颈动脉内膜中层厚度（CIMT）评估。
结果
两组在年龄、性别、体重指数、血脂谱或血压方面无显著差异。GDM组的胰岛素、稳态模型评估胰岛素抵抗（HOMA - IR）、FGF - 23水平、CIMT、左心室（LV）质量、LV质量指数和心肌性能指数（MPI）显著更高。HOMA - IR与FGF - 23呈正相关，胰岛素与FGF - 23呈正相关。此外，FGF - 23与CIMT、LV质量指数和MPI呈正相关。
结论
我们的研究结果表明，监测血清FGF - 23可能作为GDM患者亚临床动脉粥样硬化的一种非侵入性指标。
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