Is FGF-23 an early indicator of atherosclerosis and cardiac dysfunction in patients with gestational diabetes?

Area of Science:

• Endocrinology
• Cardiology
• Metabolic Disorders

Background:

• Fibroblast growth factor 23 (FGF-23) is a key hormone regulating phosphorus metabolism.
• FGF-23 is implicated in the development of myocardial hypertrophy.
• Gestational diabetes mellitus (GDM) presents unique metabolic challenges during pregnancy.

Purpose of the Study:

• To investigate the relationship between FGF-23 levels and echocardiographic parameters in GDM patients.
• To assess the association of FGF-23 with insulin resistance (IR) in women with GDM.
• To explore FGF-23 as a potential biomarker in GDM.

Main Methods:

• A comparative study involving 54 pregnant patients with GDM and 33 healthy pregnant controls.
• Evaluation of fasting insulin, fasting plasma glucose (FPG), lipid profile, oral glucose tolerance test (OGTT), FGF23, echocardiographic parameters, and carotid artery intima-media thickness (CIMT).
• Statistical analysis to determine correlations between FGF-23, IR markers (HOMA-IR, insulin), and cardiovascular parameters.

Main Results:

• Patients with GDM exhibited significantly higher levels of insulin, HOMA-IR, FGF-23, CIMT, left ventricular (LV) mass, LV mass index, and myocardial performance index (MPI) compared to controls.
• Positive correlations were observed between HOMA-IR and FGF-23, and between insulin and FGF-23.
• FGF-23 levels were positively correlated with CIMT, LV mass index, and MPI in the GDM group.

Conclusions:

• Elevated serum FGF-23 is associated with increased insulin resistance and cardiac structural/functional changes in GDM.
• FGF-23 may serve as a non-invasive biomarker for detecting subclinical atherosclerosis in pregnant women with GDM.
• Further research is warranted to elucidate the precise role of FGF-23 in GDM pathophysiology and cardiovascular risk.