ASSOCIATION OF FIBROBLAST GROWTH FACTOR 23 WITH MARKERS OF INFLAMMATION AND FIBROSIS IN DIABETIC NEPHROPATHY

The aim of the present study was to establish the disorders of mineral metabolism and production of monocyte chemoattractant protein type 1 (MCP-1) and plasminogen activator inhibitor type 1 (PAI-1) in patients with diabetic nephropathy (DN) at different stages of the disease. We examined 78 patients with DN aged from 57 to 76 years. Fibroblast growth factor 23 (FGF23), MCP-1 and PAI-1 levels in blood serum were determined by ELISA. The levels of calcium and phosphorus in the serum were established by biochemical method. Our results showed the progressive elevation of FGF-23 level in serum depending on the stage of the DN (p <0.05). High levels of FGF23 were determined already in the early stages of nephropathy. FGF23 levels in DN patients twice exceeded control group level. The highest FGF23 concentrations were detected in the late stages of the disease. Hyperphosphatemia was found in the late stages of the DN when compared with controls and early preclinical stages. We found a significant increase of MCP-1 and PAI-1 levels in patients with DN. These changes may be involved in inflammatory and fibrotic processes in the kidneys. FGF23 elevation in the peripheral blood of DN patients was associated with an increase of inflammatory and fibrosis mediators MCP-1 and PAI-1. We conclude that FGF23 increase may be considered as an important risk factor of DN progression.