The correlation between Fibroblast Growth Factor and Diabetic Nephropathy in Patients with Type 2 Diabetes

Sarah Sattar Jabbar, Sanad Baqer Mahmmad

Abstract


Background: Diabetic nephropathy (DN) is a common microvascular complication of advanced-stage diabetes mellitus. Its pathogenesis is via redox imbalance, cytokine kinetics, genetics, metabolism, and microvascular dysfunction involving the kidneys. DN causes proteinuria, edema, and hypertension, which can lead to kidney failure. Type 2 diabetes, high blood pressure, high-protein diet, and smoking are recognized risk factors. Fibroblast Growth Factor (FGF) regulates significant physiological activities and is engaged in DN, but its definitive mechanism is unclear.

Methods: In this study, 135 participants took part: 90 patients with DN (53 men, 37 women) and 45 controls. Patients were separated into:

1- Type 2 diabetes with normal-to-borderline albuminuria (n = 45; 26 males, 19 females; ACR typically < 30 mg/g creatinine, though participants with occasional readings up to 60 mg/g were included to account for day-to-day variation in urinary albumin excretion). However, the descriptive statistics (Table 3) showed that the mean ACR in this group was 47.96 ± 38.34, suggesting that the cutoff criterion may not align with the data, or that patients were misclassified. The definition should therefore be interpreted with caution.

2- Type 2 with microalbuminuria (n = 23; 16 males, 7 females; ACR = 30–300 mg/g creatinine).

3- Type 2 with macroalbuminuria (n = 22; 11 men, 11 women; ACR > 300 mg/g).

The study was conducted at Telafer Hospital (April 2021–June 2022). Serum FGF was measured using an ELISA kit. Blood (5 mL) was left to clot at room temperature for 20 minutes; the clotted blood was centrifuged at 4000 rpm for 10 minutes to separate serum. Serum fibroblast growth factor (FGF) concentration was expressed in picograms per millilitre (pg/mL). Fasting blood sugar (FBS) was measured in milligrams per decilitre (mg/dL), albumin-to-creatinine ratio (ACR) in milligrams per gram of creatinine (mg/g), and glycated haemoglobin (HbA1c) as a percentage (%).

Results: s-FGF levels were significantly higher in DN groups than controls (p < 0.001). FBS, HbA1c, and ACR were also elevated.

Conclusion: ACR is a leading early diagnostic marker of DN. FGF is a strong candidate for a diagnostic and a disease progression-tracking biomarker in DN.

Keywords: Fibroblast growth factor, diabetic nephropathy, type 2 diabetes


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References


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DOI: http://dx.doi.org/10.62940/als.v12i3.1996

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