Correlation Between Serum FGF23 And The Progression Of Type 2 Diabetes Mellitus

Objective:To investigate the change trend of serum fibroblast growth factor 23 in the progress of type 2 diabetes mellitus,and analyze its correlation with glucose and lipid metabolism,calcium and phosphorus metabolism,and further elaborate the important role of FGF23 in the occurrence and development of diabetes mellitus and its possible pathogenesis,so as to carry out early prevention and diagnosis of diabetes mellitus.Methods:a total of 494 patients who were treated in the first affiliated hospital of Xi’an medical collegehospital from January 2020 to October 2020 were collected and divided into four groups:healthy control group（NC group）,prediabetes group（pre-DM group）,type 2 diabetes group（T2DM group）,diabetes complicated with macroangiopathy group（DM complication group）,Serum FGF23 levels were measured by ELISA,and cervical vascular ultrasound was used to determine the presence of macrovascular lesions in T2DM patients.Spss23.0 software was used for statistical analysis of the data,P<0.05 showed that the difference was statistically significant.Results:1.Comparison of serum FGF23 levels among the four groups:the levels of FGF23 in pre-DM group,T2DM group and DM complication group were higher than those in NC group,the mean values of the four groups were 26.44±15.97,50.37±24.72,54.84±35.26 and 89.85±49.64,respectively,with statistical significance（P<0.05）;the levels of FGF23 in DM complication group were higher than those in pre-DM group and T2DM group,with statistical significance（P<0.05）.Spearman correlation analysis was used to observe the correlation between FGF23 and the degree of type 2 diabetes.The results showed that FGF23 was positively correlated with the degree of type 2 diabetes（r=0.336,P<0.001）,that is,with the development of type 2 diabetes,the serum FGF23 level was gradually increased.2.Correlation between FGF23 and other clinical indexes:in pre-DM group,FGF23 was positively correlated with FBG,HOMA-IR,Hb A1c and TG（P<0.05）;FGF23 was negatively correlated with HDL and 25（OH）D₃（P<0.05）;In T2DM group,FGF23 was positively correlated with Fins,HOMA-IR and Hb A1c（P<0.05）;FGF23 was negatively correlated with HDL and 25（OH）D₃（P<0.05）;In the DM complication group,FGF23 was positively correlated with FBG,HOMA-IR,Hb A1c,TG and AI HOMA-β、HDL and 25（OH）D₃were negatively correlated（P<0.05）.3.Influencing factors of FGF23:by multiple linear stepwise regression analysis,FBG,Hb A1c,LDL,25（OH）D₃were the independent influencing factors of FGF23（P<0.05）.4.The area under the ROC curve（AUC）of FGF23 was 0.761 for prediabetes,0.776 for T2DM and 0.781 for macroangiopathy in type 2 diabetes mellitus,which means FGF23 has higher predictive value for macroangiopathy in type 2 diabetes mellitus.Conclusion:1.The level of FGF23 gradually increased in healthy people,pre diabetes,type 2 diabetes and type 2 diabetic patients with macroangiopathy,indicating that FGF23 plays an important role in the occurrence and development of type 2 diabetes。2.There was a significant correlation between FGF23 and fasting blood glucose,glycosylated hemoglobin,insulin resistance,25（OH）D3,suggesting that FGF23has a potential relationship with glucose metabolism disorder and calcium and phosphorus metabolism.3.The increase of serum FGF23 level can be used as a risk factor for the occurrence of prediabetes mellitus,type 2 diabetes mellitus and its macrovascular diseases,and has a certain predictive value,among which the prediction value of macroangiopathytype 2 diabetes mellitus is higher.