Jocelyn S Garland1, Rachel M Holden2, Robert Ross3, Michael A Adams4, Robert L Nolan5, Wilma M Hopman6, A Ross Morton2. 1. Department of Medicine, Queen's University, Kingston, ON, Canada; Queen's University Vascular Calcification Investigators, Queen's University, Kingston, ON, Canada. Electronic address: garlandj@queensu.ca. 2. Department of Medicine, Queen's University, Kingston, ON, Canada; Queen's University Vascular Calcification Investigators, Queen's University, Kingston, ON, Canada. 3. School of Kinesiology and Health Studies, Departments of Endocrinology and Metabolism, Queen's University, Kingston, ON, Canada. 4. Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada. 5. Queen's University Vascular Calcification Investigators, Queen's University, Kingston, ON, Canada; Department of Radiology, Queen's University, Kingston, ON, Canada. 6. Queen's University Vascular Calcification Investigators, Queen's University, Kingston, ON, Canada; Clinical Research Center, Kingston General Hospital, and Department of Community Health and Epidemiology, Queen's University, Kingston, Ontario, Canada.
Abstract
AIM: To determine the associations between insulin resistance, fibroblast growth factor 23 (FGF-23), and coronary artery calcification (CAC) in chronic kidney disease (CKD) patients. INTRODUCTION: FGF-23 is associated with atherosclerosis and cardiovascular disease, but its association with insulin resistance in CKD has not been explored. SUBJECTS: Cross sectional study of 72 stage 3-5 CKD patients receiving care in Ontario, Canada. MATERIALS AND METHODS: Insulin resistance was measured by the homeostasis model assessment of insulin resistance (HOMA-IR), FGF-23 was measured by carboxyl terminal enzyme linked immunoassay (ctFGF-23) and CAC was measured by multi-slice computed tomography. RESULTS: Median HOMA-IR was 2.19μU/ml (interquartile range 1.19 to 3.94). Patients with HOMA-IR>2.2 had greater ctFGF-23 (179.7 vs 109.6; P=0.03), and 40% higher log CAC scores (2.09±0.87 vs 1.58±1.26; P=0.049). Multivariable linear regression adjusted for 1,25 dihydroxyvitamin D, kidney function, and parathyroid hormone revealed insulin resistance was a risk factor for greater log ctFGF-23 levels (log HOMA IR β=0.37; 95% confidence interval 0.14 to 0.59; P=0.002). CONCLUSIONS: Insulin resistant CKD patients demonstrated higher FGF-23 levels, and increased CAC, while PO4 levels remained normal, suggesting a potential link between insulin resistance and PO4 homeostasis in CKD.
AIM: To determine the associations between insulin resistance, fibroblast growth factor 23 (FGF-23), and coronary artery calcification (CAC) in chronic kidney disease (CKD) patients. INTRODUCTION:FGF-23 is associated with atherosclerosis and cardiovascular disease, but its association with insulin resistance in CKD has not been explored. SUBJECTS: Cross sectional study of 72 stage 3-5 CKD patients receiving care in Ontario, Canada. MATERIALS AND METHODS:Insulin resistance was measured by the homeostasis model assessment of insulin resistance (HOMA-IR), FGF-23 was measured by carboxyl terminal enzyme linked immunoassay (ctFGF-23) and CAC was measured by multi-slice computed tomography. RESULTS: Median HOMA-IR was 2.19μU/ml (interquartile range 1.19 to 3.94). Patients with HOMA-IR>2.2 had greater ctFGF-23 (179.7 vs 109.6; P=0.03), and 40% higher log CAC scores (2.09±0.87 vs 1.58±1.26; P=0.049). Multivariable linear regression adjusted for 1,25 dihydroxyvitamin D, kidney function, and parathyroid hormone revealed insulin resistance was a risk factor for greater log ctFGF-23 levels (log HOMA IR β=0.37; 95% confidence interval 0.14 to 0.59; P=0.002). CONCLUSIONS:Insulin resistant CKD patients demonstrated higher FGF-23 levels, and increased CAC, while PO4 levels remained normal, suggesting a potential link between insulin resistance and PO4 homeostasis in CKD.
Authors: Caitlyn Vlasschaert; Amy J M McNaughton; Michael Chong; Elina K Cook; Wilma Hopman; Bryan Kestenbaum; Cassianne Robinson-Cohen; Jocelyn Garland; Sarah M Moran; Guillaume Paré; Catherine M Clase; Mila Tang; Adeera Levin; Rachel Holden; Michael J Rauh; Matthew B Lanktree Journal: J Am Soc Nephrol Date: 2022-02-23 Impact factor: 14.978
Authors: Ludmilla Bär; Martina Feger; Abul Fajol; Lars-Oliver Klotz; Shufei Zeng; Florian Lang; Berthold Hocher; Michael Föller Journal: Proc Natl Acad Sci U S A Date: 2018-05-14 Impact factor: 11.205