Association of α-klotho with subclinical carotid atherosclerosis in subjects with type 1 diabetes mellitus.


Journal

Cardiovascular diabetology
ISSN: 1475-2840
Titre abrégé: Cardiovasc Diabetol
Pays: England
ID NLM: 101147637

Informations de publication

Date de publication:
11 10 2022
Historique:
received: 23 07 2022
accepted: 15 09 2022
entrez: 11 10 2022
pubmed: 12 10 2022
medline: 14 10 2022
Statut: epublish

Résumé

Compelling evidence suggests that the fibroblast growth factor 23 (FGF23) / α-klotho axis is impaired in subjects with diabetes mellitus. We examined the relationship between parameters related to calcium/phosphate homeostasis, including FGF23 and α-klotho, and subclinical carotid atherosclerosis burden in type 1 diabetes mellitus (T1D) subjects. This cross-sectional study involved 226 subjects with T1D and 147 age-, sex- and plaque-matched, non-diabetic (non-T1D) subjects, both with normal renal function. Carotid ultrasound was performed to determine the presence and burden of atheromatous plaques. Concentrations of the intact form of FGF23 and α-klotho were assessed by ELISA. Calcium, phosphate, parathyroid hormone, and vitamin D levels were also determined. Negative binomial regression models were used to examine relationship between parameters studied and subclinical carotid atherosclerosis. Only FGF23 was increased in T1D compared with non-diabetic subjects (> 2-fold; p < 0.05). α-klotho was higher in subjects with subclinical carotid atherosclerosis (1.4-fold, p < 0.05). Regression analysis revealed that the log α-klotho concentration was positively associated with the presence of subclinical carotid atherosclerosis both in T1D subjects (incidence rate ratio [IRR]: 1.41; 95% confidence interval [CI], 1.06-1.89; p < 0.05) and in non-T1D subjects (IRR: 1.65; 95% CI, 1.02-2.75; p < 0.05). The models also showed that age, smoking and albuminuria-to-creatinine ratio were positively associated with subclinical carotid atherosclerosis in T1D subjects. Interestingly, sex-related protection against plaque was also revealed in T1D women. Higher α-klotho was associated with subclinical carotid atherosclerotic in the absence of kidney dysfunction. This finding also points to a new pathophysiological pathway involved in the development and progression of this complication.

Sections du résumé

BACKGROUND
Compelling evidence suggests that the fibroblast growth factor 23 (FGF23) / α-klotho axis is impaired in subjects with diabetes mellitus. We examined the relationship between parameters related to calcium/phosphate homeostasis, including FGF23 and α-klotho, and subclinical carotid atherosclerosis burden in type 1 diabetes mellitus (T1D) subjects.
METHODS
This cross-sectional study involved 226 subjects with T1D and 147 age-, sex- and plaque-matched, non-diabetic (non-T1D) subjects, both with normal renal function. Carotid ultrasound was performed to determine the presence and burden of atheromatous plaques. Concentrations of the intact form of FGF23 and α-klotho were assessed by ELISA. Calcium, phosphate, parathyroid hormone, and vitamin D levels were also determined. Negative binomial regression models were used to examine relationship between parameters studied and subclinical carotid atherosclerosis.
RESULTS
Only FGF23 was increased in T1D compared with non-diabetic subjects (> 2-fold; p < 0.05). α-klotho was higher in subjects with subclinical carotid atherosclerosis (1.4-fold, p < 0.05). Regression analysis revealed that the log α-klotho concentration was positively associated with the presence of subclinical carotid atherosclerosis both in T1D subjects (incidence rate ratio [IRR]: 1.41; 95% confidence interval [CI], 1.06-1.89; p < 0.05) and in non-T1D subjects (IRR: 1.65; 95% CI, 1.02-2.75; p < 0.05). The models also showed that age, smoking and albuminuria-to-creatinine ratio were positively associated with subclinical carotid atherosclerosis in T1D subjects. Interestingly, sex-related protection against plaque was also revealed in T1D women.
CONCLUSION
Higher α-klotho was associated with subclinical carotid atherosclerotic in the absence of kidney dysfunction. This finding also points to a new pathophysiological pathway involved in the development and progression of this complication.

Identifiants

pubmed: 36221075
doi: 10.1186/s12933-022-01640-3
pii: 10.1186/s12933-022-01640-3
pmc: PMC9554979
doi:

Substances chimiques

Parathyroid Hormone 0
Phosphates 0
Vitamin D 1406-16-2
Fibroblast Growth Factors 62031-54-3
Creatinine AYI8EX34EU
Glucuronidase EC 3.2.1.31
Calcium SY7Q814VUP

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

207

Informations de copyright

© 2022. The Author(s).

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Auteurs

Esmeralda Castelblanco (E)

Endocrinology, Metabolism and Lipid Research Division, Department of Medicine, Washington University School of Medicine, 63110, St Louis, MO, USA.
Unitat de Suport a la Recerca Barcelona, Institut Universitari d'Investigació en Atenció Primària Jordi Gol i Gurina (IDIAP Jordi Gol), 08007, Barcelona, Spain.

Marta Hernández (M)

Department of Endocrinology & Nutrition, Hospital Universitari Arnau de Vilanova & Institut d'Investigació Biomédica de Lleida (IRB Lleida), 25198, Lleida, Spain.

Nuria Alonso (N)

CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, 28029, Madrid, Spain.
Department of Endocrinology & Nutrition, Hospital Universitari Germans Trias i Pujol, 08916, Badalona, Spain.
Department of Medicine, Autonomous University of Barcelona, 08916, Barcelona, Spain.

Aina Ribes-Betriu (A)

Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), 08041, Barcelona, Spain.

Jordi Real (J)

Unitat de Suport a la Recerca Barcelona, Institut Universitari d'Investigació en Atenció Primària Jordi Gol i Gurina (IDIAP Jordi Gol), 08007, Barcelona, Spain.
CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, 28029, Madrid, Spain.

Minerva Granado-Casas (M)

CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, 28029, Madrid, Spain.
Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), 08041, Barcelona, Spain.
Department of Endocrinology & Nutrition, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain.

Joana Rossell (J)

CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, 28029, Madrid, Spain.
Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), 08041, Barcelona, Spain.
Department of Endocrinology & Nutrition, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain.

Marina Idalia Rojo-López (MI)

Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), 08041, Barcelona, Spain.
Department of Endocrinology & Nutrition, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain.

Adriana Silvia Dusso (AS)

Endocrinology, Metabolism and Lipid Research Division, Department of Medicine, Washington University School of Medicine, 63110, St Louis, MO, USA.

Josep Julve (J)

CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, 28029, Madrid, Spain. JJulve@santpau.cat.
Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), 08041, Barcelona, Spain. JJulve@santpau.cat.
Department of Endocrinology & Nutrition, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain. JJulve@santpau.cat.

Didac Mauricio (D)

CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, 28029, Madrid, Spain. didacmauricio@gmail.com.
Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), 08041, Barcelona, Spain. didacmauricio@gmail.com.
Department of Endocrinology & Nutrition, Hospital de la Santa Creu i Sant Pau, 08041, Barcelona, Spain. didacmauricio@gmail.com.
Faculty of Medicine, University of Vic (UVIC/UCC), 08500, Vic, Spain. didacmauricio@gmail.com.

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