Diabetes mellitus modifies the association between chronic kidney disease-mineral and bone disorder biomarkers and aortic stiffness in peritoneal dialysis patients

• Published in: Scientific reports Vol. 14; no. 1; p. 4554
• Main Authors: Huang, Hsiang-Jung, Hsu, Bang-Gee, Wang, Chih-Hsien, Tsai, Jen-Pi, Chen, Yi-Hsin, Hung, Szu-Chun, Lin, Yu-Li
• Format: Journal Article
• Language: English
• Published: England Nature Publishing Group 24.02.2024; Nature Publishing Group UK; Nature Portfolio
• Subjects: Adult; Aged; alpha-2-HS-Glycoprotein; Aorta; Biomarkers; Bone diseases; Chronic Kidney Disease-Mineral and Bone Disorder; Diabetes; Diabetes Mellitus; Dialysis; Enzyme-linked immunosorbent assay; Fibroblast growth factor 23; Fibroblast Growth Factors; Humans; Kidney diseases; Kidneys; Klotho protein; Middle Aged; Parathyroid hormone; Peritoneal Dialysis; Peritoneum; Pulse Wave Analysis; Renal Insufficiency, Chronic - therapy; Vascular Stiffness; Wave velocity
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-55364-3

This study aimed to investigate the relationship of four chronic kidney disease-mineral and bone disorder (CKD-MBD) biomarkers, including intact parathyroid hormone (PTH), fibroblast growth factor 23 (FGF23), soluble klotho, and fetuin-A, with aortic stiffness in peritoneal dialysis (PD) patients, comparing those with and without diabetes mellitus (DM). A total of 213 patients (mean age 58 ± 14 years; 81 (38.0%) patients with DM) were enrolled. Their aortic pulse wave velocity (PWV) was measured using pressure applanation tonometry, while serum intact PTH, FGF23, α-klotho, and fetuin-A levels were measured using enzyme-linked immunosorbent assay. Overall, patients with DM had higher aortic PWV than those without (9.9 ± 1.8 vs. 8.6 ± 1.4 m/s, p < 0.001). Among the four CKD-MBD biomarkers, FGF23 levels were significantly lower in DM group (462 [127-1790] vs. 1237 [251-3120] pg/mL, p = 0.028) and log-FGF23 independently predicted aortic PWV in DM group (β: 0.61, 95% confidence interval: 0.06-1.16, p = 0.029 in DM group; β: 0.10, 95% confidence interval: - 0.24-0.45, p = 0.546 in nonDM group; interaction p = 0.016). In conclusion, the association between FGF23 and aortic PWV was significantly modified by DM status in PD patients.