FIBROBLAST GROWTH FACTOR-23 AND HYPOVITAMINAEMIA D IN ANAEMIA OF

TYPE 2 DIABETIC NEPHROPATHY

Grigorios G. Dimas1, Fotios S. Iliadis1, Ilias E. Kanellos1, Thomas J. Tegos2, Sofia G. Spiroglou3, Spiros D. Fotiadis1, Ioannis M. Karamouzis1, Christos G Savopoulos1, Apostolos I. Hatzitolios1, Dimitrios M. Grekas1.

 1 1st Propaedeutic Medical Department, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece2 1st Neurology Medical Department, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece3 Biochemistry Laboratory, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece

Background

• Clinical and experimental evidence support a role for fibroblast growth factor (FGF-23) in

promoting osteoclastic bone resorption, but the precise molecular mechanisms are not yet

fully understood. FGF-23 has been implicated in chronic kidney disease (CKD) and is

important in humans for osteogenesis.

• The role of vitamin D in type 2 diabetes is well recognized, but its relation to glucose

metabolism is not well studied.

• The observation that anaemia begins in diabetic nephropathy (DN) before the other causes

of CKD leaded us to investigate this hypothesis.

Aim

• The aim of the present study was to determine the serum levels of FGF-23 and

1.25(OH)2D3 and to investigate their potential correlation with anaemia, in early

stages of CKD and type 2 DN.

Methods

• CKD patients of stages 1 and 2 with type II DN (n=50) were included. As controls, there

were healthy individuals (n=40). 1.25(OH)2D3 and FGF-23 levels were measured by an

ELISA method.

Results

• The levels of 1.25(OH)2D3 were significantly higher in patients than in the control groups

(40±3, p<0.0001), FGF-23 were significantly higher in patients (0.5±0.1, p<0.004) and

hemoglobin (Hb) was (4±1, p<0.005). There was negative strong correlation between FGF-23

and 1.25(OH)2D3 (r= -0.75, p<0.005) such as FGF-23 and Hb (r= -0.7, p<0.005).

• There was positive strong correlation between 1.25(OH)2D3 and Hb (r= 0.7, p<0.0001.

Conclusion

• This study suggests that serum levels of FGF-23 and 1.25(OH)2D3 were found to be

independent risk factors of anaemia in early stages of type II diabetic nephropathy.