In:
Journal of Clinical Medicine, MDPI AG, Vol. 8, No. 4 ( 2019-04-03), p. 448-
Abstract:
Background: Diabetic foot syndrome (DFS) is a prevalent complication in the diabetic population and a major cause of hospitalizations. Diverse clinical studies have related alterations in the system formed by fibroblast growth factor (FGF)-23 and Klotho (KL) with vascular damage. In this proof-of-concept study, we hypothesize that the levels of FGF23 and Klotho are altered in DFS patients. Methods: Twenty patients with limb amputation due to DFS, 37 diabetic patients without DFS, and 12 non-diabetic cadaveric organ donors were included in the study. Serum FGF23/Klotho and inflammatory markers were measured by enzyme-linked immunosorbent assay (ELISA). Protein and gene expression levels in the vascular samples were determined by immunohistochemistry and quantitative real-time PCR, respectively. Results: Serum Klotho is significantly reduced and FGF23 is significantly increased in patients with DFS (p 〈 0.01). Vascular immunoreactivity and gene expression levels for Klotho were decreased in patients with DFS (p 〈 0.01). Soluble Klotho was inversely related to serum C-reactive protein (r = −0.30, p 〈 0.05). Vascular immunoreactivities for Klotho and IL6 showed an inverse association (r = −0.29, p 〈 0.04). Similarly, vascular gene expression of KL and IL6 were inversely associated (r = −0.31, p 〈 0.05). Logistic regression analysis showed that higher Klotho serum concentrations and vascular gene expression levels were related to a lower risk of DFS, while higher serum FGF23 was associated with a higher risk for this complication. Conclusion: FGF23/Klotho system is associated with DFS, pointing to a new pathophysiological pathway involved in the development and progression of this complication.
Type of Medium:
Online Resource
ISSN:
2077-0383
Language:
English
Publisher:
MDPI AG
Publication Date:
2019
detail.hit.zdb_id:
2662592-1
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