Xuanli Zhong, Zhanyun Liang, Haiming Liao, Yuanyuan Zhan, Ge Li, Huanping Wu, Jinying Li
{"title":"血清FGF23和DPP4水平作为2型糖尿病合并冠心病患者冠状动脉疾病严重程度的生物标志物","authors":"Xuanli Zhong, Zhanyun Liang, Haiming Liao, Yuanyuan Zhan, Ge Li, Huanping Wu, Jinying Li","doi":"10.2147/IJGM.S517028","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the relationship between serum fibroblast growth factor 23 (FGF23) and dipeptidyl peptidase 4 (DPP4) levels, and the severity and prognosis of coronary artery disease (CAD) in patients with type 2 diabetes mellitus (T2DM) and coronary heart disease (CHD).</p><p><strong>Methods: </strong>A total of 113 patients with both T2DM and CHD (T2DM+CHD group) and 74 patients with T2DM without CHD (T2DM-only group) who underwent coronary angiography between January 2021 and June 2023 were enrolled. Based on Gensini scores, the T2DM+CHD group was further divided into three subgroups: mild (n=38), moderate (n=46), and severe (n=29) lesions. Serum levels of FGF23 and DPP4 were determined using enzyme-linked immunosorbent assay (ELISA). Correlation analysis and logistic regression were conducted to assess the association between biomarker levels and both disease severity and prognosis. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of these biomarkers.</p><p><strong>Results: </strong>Serum levels of FGF23 and DPP4 were significantly higher in the T2DM+CHD group than in the T2DM-only group (P<0.05), and increased progressively with the severity of CAD (P<0.05). A positive correlation was observed between the levels of these biomarkers and CAD severity (r=0.714 for FGF23; r=0.437 for DPP4; P<0.05). Patients with poor prognosis exhibited increased left atrial diameter (LAD) and biomarker levels, along with reduced left ventricular ejection fraction (LVEF) (P<0.05). Multivariate analysis identified increased LAD, moderate-to-severe CAD, and elevated levels of FGF23/DPP4 as independent risk factors for poor prognosis, while higher LVEF served as a protective factor (P<0.05). Moreover, a combined predictive model using both FGF23 and DPP4 demonstrated superior diagnostic performance (AUC=0.921; P<0.05) compared to the use of each biomarker individually.</p><p><strong>Conclusion: </strong>Elevated serum levels of FGF23 and DPP4 are significantly associated with both the severity and poor prognosis of CAD in patients with T2DM and CHD. These findings suggest that FGF23 and DPP4 may serve as valuable biomarkers for risk stratification and clinical decision-making in this patient population.</p>","PeriodicalId":14131,"journal":{"name":"International Journal of General Medicine","volume":"18 ","pages":"1757-1764"},"PeriodicalIF":2.1000,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11960471/pdf/","citationCount":"0","resultStr":"{\"title\":\"Serum FGF23 and DPP4 Levels as Biomarkers for Coronary Artery Disease Severity in Type 2 Diabetic Patients with Coronary Heart Disease.\",\"authors\":\"Xuanli Zhong, Zhanyun Liang, Haiming Liao, Yuanyuan Zhan, Ge Li, Huanping Wu, Jinying Li\",\"doi\":\"10.2147/IJGM.S517028\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study aimed to evaluate the relationship between serum fibroblast growth factor 23 (FGF23) and dipeptidyl peptidase 4 (DPP4) levels, and the severity and prognosis of coronary artery disease (CAD) in patients with type 2 diabetes mellitus (T2DM) and coronary heart disease (CHD).</p><p><strong>Methods: </strong>A total of 113 patients with both T2DM and CHD (T2DM+CHD group) and 74 patients with T2DM without CHD (T2DM-only group) who underwent coronary angiography between January 2021 and June 2023 were enrolled. Based on Gensini scores, the T2DM+CHD group was further divided into three subgroups: mild (n=38), moderate (n=46), and severe (n=29) lesions. Serum levels of FGF23 and DPP4 were determined using enzyme-linked immunosorbent assay (ELISA). Correlation analysis and logistic regression were conducted to assess the association between biomarker levels and both disease severity and prognosis. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of these biomarkers.</p><p><strong>Results: </strong>Serum levels of FGF23 and DPP4 were significantly higher in the T2DM+CHD group than in the T2DM-only group (P<0.05), and increased progressively with the severity of CAD (P<0.05). A positive correlation was observed between the levels of these biomarkers and CAD severity (r=0.714 for FGF23; r=0.437 for DPP4; P<0.05). Patients with poor prognosis exhibited increased left atrial diameter (LAD) and biomarker levels, along with reduced left ventricular ejection fraction (LVEF) (P<0.05). Multivariate analysis identified increased LAD, moderate-to-severe CAD, and elevated levels of FGF23/DPP4 as independent risk factors for poor prognosis, while higher LVEF served as a protective factor (P<0.05). Moreover, a combined predictive model using both FGF23 and DPP4 demonstrated superior diagnostic performance (AUC=0.921; P<0.05) compared to the use of each biomarker individually.</p><p><strong>Conclusion: </strong>Elevated serum levels of FGF23 and DPP4 are significantly associated with both the severity and poor prognosis of CAD in patients with T2DM and CHD. These findings suggest that FGF23 and DPP4 may serve as valuable biomarkers for risk stratification and clinical decision-making in this patient population.</p>\",\"PeriodicalId\":14131,\"journal\":{\"name\":\"International Journal of General Medicine\",\"volume\":\"18 \",\"pages\":\"1757-1764\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-03-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11960471/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of General Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/IJGM.S517028\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of General Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/IJGM.S517028","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Serum FGF23 and DPP4 Levels as Biomarkers for Coronary Artery Disease Severity in Type 2 Diabetic Patients with Coronary Heart Disease.
Objective: This study aimed to evaluate the relationship between serum fibroblast growth factor 23 (FGF23) and dipeptidyl peptidase 4 (DPP4) levels, and the severity and prognosis of coronary artery disease (CAD) in patients with type 2 diabetes mellitus (T2DM) and coronary heart disease (CHD).
Methods: A total of 113 patients with both T2DM and CHD (T2DM+CHD group) and 74 patients with T2DM without CHD (T2DM-only group) who underwent coronary angiography between January 2021 and June 2023 were enrolled. Based on Gensini scores, the T2DM+CHD group was further divided into three subgroups: mild (n=38), moderate (n=46), and severe (n=29) lesions. Serum levels of FGF23 and DPP4 were determined using enzyme-linked immunosorbent assay (ELISA). Correlation analysis and logistic regression were conducted to assess the association between biomarker levels and both disease severity and prognosis. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of these biomarkers.
Results: Serum levels of FGF23 and DPP4 were significantly higher in the T2DM+CHD group than in the T2DM-only group (P<0.05), and increased progressively with the severity of CAD (P<0.05). A positive correlation was observed between the levels of these biomarkers and CAD severity (r=0.714 for FGF23; r=0.437 for DPP4; P<0.05). Patients with poor prognosis exhibited increased left atrial diameter (LAD) and biomarker levels, along with reduced left ventricular ejection fraction (LVEF) (P<0.05). Multivariate analysis identified increased LAD, moderate-to-severe CAD, and elevated levels of FGF23/DPP4 as independent risk factors for poor prognosis, while higher LVEF served as a protective factor (P<0.05). Moreover, a combined predictive model using both FGF23 and DPP4 demonstrated superior diagnostic performance (AUC=0.921; P<0.05) compared to the use of each biomarker individually.
Conclusion: Elevated serum levels of FGF23 and DPP4 are significantly associated with both the severity and poor prognosis of CAD in patients with T2DM and CHD. These findings suggest that FGF23 and DPP4 may serve as valuable biomarkers for risk stratification and clinical decision-making in this patient population.
期刊介绍：
The International Journal of General Medicine is an international, peer-reviewed, open access journal that focuses on general and internal medicine, pathogenesis, epidemiology, diagnosis, monitoring and treatment protocols. The journal is characterized by the rapid reporting of reviews, original research and clinical studies across all disease areas.
A key focus of the journal is the elucidation of disease processes and management protocols resulting in improved outcomes for the patient. Patient perspectives such as satisfaction, quality of life, health literacy and communication and their role in developing new healthcare programs and optimizing clinical outcomes are major areas of interest for the journal.
As of 1st April 2019, the International Journal of General Medicine will no longer consider meta-analyses for publication.
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