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Abstract: PO2464

Apelin and FGF-23 as Biomarkers for Vascular Calcification in Type 2 Diabetic Patients with CKD

Session Information

Category: CKD (Non-Dialysis)

  • 2103 CKD (Non-Dialysis): Mechanisms


  • Afonso, Rita Serra, Centro Hospitalar do Algarve EPE, Faro, Faro, Portugal
  • Cabrita, Ana, Centro Hospitalar do Algarve EPE, Faro, Faro, Portugal
  • Silva, Ana Paula, Centro Hospitalar do Algarve EPE, Faro, Faro, Portugal

Cardiovascular disease is the leading cause of death in chronic kidney disease (CKD) patients. CKD-Mineral and Bone Disorder occur from the earliest stages of estimated glomerular filtration rate (eGFR) loss and is associated with an increased risk of vascular calcification (VC), which is one of the strongest predictors of cardiovascular risk and mortality in patients with CKD. Apelin and FGF-23 have emerged as potential markers of VC. The main objective of this study is to evaluate the role of apelin and fibroblast growth factor 23 (FGF-23) in the development of VC in type 2 diabetic CKD patients


Observational prospective study enrolling 150 type 2 diabetes mellitus patients with CKD. Sample characteristics were analyzed using descriptive statistics. Independent-samples t-test, Pearson's correlation test and partial correlations were used to evaluate the association and correlation of several demographic and clinical parameters with vascular calcification score (VCS). Univariate logistic regression and multivariate logistic regression were used to find out predictors of VC.


Lower levels of apelin, 1,25-dihydroxycholecalciferol and eGFR were negatively associated with higher VCS and higher levels of phosphate, calcium × phosphate, parathyroid hormone, interleukin-6 and FGF-23 were positively associated with higher VCS. A negative correlation was found between VCS and apelin (r = -0.429, p<0.0001), and between apelin and FGF-23 (r = -0.483, p<0.0001), while a positive correlation was found between VCS and FGF-23 (r =0.232, p=0.005). Variables significantly associated with VCS in univariate logistic regression analysis were used in multivariable logistic regression analysis. Multivariable logistic regression analysis demonstrated that lower apelin levels and diminished eGFR were associated with a higher VCS. Contrarily, higher levels of inorganic phosphorus and FGF-23 were linked with a higher VCSA.


The results suggest that apelin and FGF-23 are predictors of VC on type 2 diabetic patients with CKD. Therefore, these osteo-mineral markers might be used as diagnostic/therapeutic targets in order to improve management of CKD complications.