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成纤维细胞生长因子23与糖尿病患者的心血管风险——心脏病专家请注意

Fibroblast Growth Factor 23 and Cardiovascular Risk in Diabetes Patients-Cardiologists Be Aware.

作者信息

Kurpas Anna, Supel Karolina, Wieczorkiewicz Paulina, Bodalska Duleba Joanna, Zielinska Marzenna

机构信息

Department of Interventional Cardiology, Medical University of Lodz, 92-213 Lodz, Poland.

Diabetes Outpatient Clinic 'Poradnia Nowa', 90-631 Lodz, Poland.

出版信息

Metabolites. 2022 May 30;12(6):498. doi: 10.3390/metabo12060498.

Abstract

Numerous clinical studies have indicated that elevated FGF23 (fibroblast growth factor 23) levels may be associated with cardiovascular (CV) mortality, especially in patients with chronic kidney disease. The purpose of this study was to examine the hypothesis that FGF23 may be a potent CV risk factor among patients with long-standing type 2 diabetes mellitus (T2DM). Research was performed utilizing patients with T2DM and regular outpatient follow-up care. Baseline characteristics determined by laboratory tests were recorded. Serum FGF23 levels were detected using a sandwich enzyme-linked immunosorbent assay. All patients underwent echocardiograms and 12-lead electrocardiograms. Data records of 102 patients (males: 57%) with a median age of 69 years (interquartile range (IQR) 66.0-74.0) were analyzed. Baseline characteristics indicated that one-third (33%) of patients suffered from ischemic heart disease (IHD), and the median time elapsed since diagnosis with T2DM was 19 years (IQR 14.0-25.0). The hemoglobin A1c, estimated glomerular filtration rate, and FGF23 values were, respectively, as follows: 6.85% (IQR 6.5-7.7), 80 mL/min/1.73 m (IQR 70.0-94.0), and 253.0 pg/mL (IQR 218.0-531.0). The study revealed that FGF23 was elevated in all patients, regardless of IHD status. Thus, the role of FGF23 as a CV risk factor should not be overestimated among patients with T2DM and good glycemic control.

摘要

众多临床研究表明,成纤维细胞生长因子23(FGF23)水平升高可能与心血管(CV)死亡率相关,尤其是在慢性肾脏病患者中。本研究的目的是检验FGF23可能是长期2型糖尿病(T2DM)患者中一种强效CV危险因素的假设。研究对象为接受常规门诊随访护理的T2DM患者。记录通过实验室检测确定的基线特征。使用夹心酶联免疫吸附测定法检测血清FGF23水平。所有患者均接受了超声心动图和12导联心电图检查。对102例患者(男性占57%)的数据记录进行了分析,这些患者的中位年龄为69岁(四分位间距(IQR)为66.0 - 74.0)。基线特征表明,三分之一(33%)的患者患有缺血性心脏病(IHD),自诊断为T2DM以来的中位时间为19年(IQR为14.0 - 25.0)。糖化血红蛋白、估计肾小球滤过率和FGF23值分别如下:6.85%(IQR为6.5 - 7.7)、80 mL/min/1.73 m²(IQR为70.0 - 94.0)和253.0 pg/mL(IQR为218.0 - 531.0)。研究显示,无论IHD状态如何,所有患者的FGF23均升高。因此,在血糖控制良好的T2DM患者中,不应高估FGF23作为CV危险因素的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0380/9254740/83dda0c6ca5a/metabolites-12-00498-g001.jpg

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