Relationship Between Fibroblast Growth Factor 19 and Diabetic Retinopathy in Patients with Type 2 Diabetes Mellitus

Figures & data

Table 1 Characteristics of Patients with T2DM

	Diabetic Retinopathy (-)	Diabetic Retinopathy (+)	p-value
n	280	77
Age (years)	56.8 ± 11.3	57.4 ± 11.2	0.690
Men (%)	142 (50.7)	41 (53.2)	0.694
Hypertension, n (%)	159 (56.8)	51 (66.2)	0.136
Hyperlipidemia, n (%)	167 (59.6)	44 (57.1)	0.693
Body mass index (kg/m^2)	26.2 ± 4.2	25.1 ± 4.3	0.040
Duration of diabetes (years)	2.0 (0.2–8.8)	11.0 (4.5–20.0)	<0.001
Systolic BP (mmHg)	133.6 ± 17.9	134.6 ± 15.8	0.640
Diastolic BP (mmHg)	78.3 ± 12.1	78.6 ± 11.2	0.847
HbA1c (%)	7.5 ± 1.7	8.3 ± 1.7	<0.001
HbA1c (mmol/mol)	58 ± 19	67 ± 18	<0.001
Triglycerides (mmol/L)	1.3 (1.0–2.0)	1.4 (1.0–2.0)	0.976
LDL-C (mmol/L)	2.6 ± 0.8	2.5 ± 0.8	0.113
HDL-C (mmol/L)	1.3 ± 0.3	1.2 ± 0.3	0.434
Total cholesterol (mmol/L)	4.4 ± 1.1	4.2 ± 1.1	0.158
UACR (mg/g Cr)	11.1 (6.8–27.0)	21.3 (10.4–65.8)	<0.001
UACR ≥ 30 mg/g Cr, n (%)	64 (22.9)	31 (40.3)	0.002
eGFR (mL/min/1.73m^2)	98.1 ± 14.1	94.9 ± 16.4	0.090
Fibrinogen (μmol/L)	8.6 (7.6–10.0)	9.2 (8.3–10.5)	0.016
FGF19 (pg/mL)	131.1 (92.6–200.1)	104.7 (71.0–170.1)	0.010
Use of OHAs, n (%)	166 (59.3)	43 (55.8)	0.587
Use of insulin, n (%)	28 (10.0)	22 (28.6)	<0.001

Notes: Values are expressed as mean ± standard deviation or median (interquartile range). Statistical analysis was performed using the Mann-Whitney U-test, Student’s t-test, or the chi-square test.

Abbreviations: T2DM, type 2 diabetes mellitus; BP, blood pressure; HbA_1c, glycated hemoglobin; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; UACR, urinary albumin-to-creatinine ratio; eGFR, estimated glomerular filtration rate; FGF19, fibroblast growth factor 19; OHAs, oral hypoglycemic agents.

Table 2 Characteristics of Patients with T2DM According to Serum FGF19 Tertiles

Serum FGF19 Level (pg/mL)	Tertile 1 (<98.5)	Tertile 2 (98.5–167.4)	Tertile 3 (≥167.4)	p-value
n	119	119	119
Age (years)	55.3 ± 11.6	57.4 ± 10.2	58.1 ± 11.8	0.140
Men (%)	62 (52.1)	61 (51.3)	60 (50.4)	0.967
Hypertension, n (%)	70 (58.8)	66 (55.5)	74 (62.2)	0.574
Hyperlipidemia, n (%)	72 (60.5)	68 (57.1)	71 (59.7)	0.860
Body mass index (kg/m^2)	27.0 ± 4.4	25.6 ± 4.3	25.4 ± 3.9	0.006
Duration of diabetes (years)	4.0 (0.4–11.0)	4.0 (0.2–10.0)	3.0 (0.2–10.0)	0.831
Systolic BP (mmHg)	132.8 ± 14.7	133.3 ± 16.5	135.3 ± 20.6	0.490
Diastolic BP (mmHg)	78.2 ± 11.1	77.9 ± 11.0	79.0 ± 13.5	0.788
HbA1c (%)	7.7 ± 1.6	7.9 ± 2.0	7.4 ± 1.6	0.056
HbA1c (mmol/mol)	60 ± 17	63 ± 22	57 ± 17	0.056
Triglycerides (mmol/L)	1.4 (1.0–2.0)	1.3 (1.0–2.0)	1.3 (1.0–2.0)	0.822
LDL-C (mmol/L)	2.5 ± 0.7	2.6 ± 0.8	2.7 ± 0.9	0.036
HDL-C (mmol/L)	1.3 ± 0.4	1.3 ± 0.3	1.3 ± 0.3	0.712
Total cholesterol (mmol/L)	4.2 ± 1.0	4.4 ± 1.1	4.5 ± 1.2	0.055
UACR (mg/g Cr)	11.9 (7.0–29.8)	12.6 (7.2–31.2)	13.7 (7.3–43.5)	0.807
UACR ≥ 30 mg/g Cr, n (%)	29 (24.4)	31 (26.1)	35 (29.4)	0.669
eGFR (mL/min/1.73m^2)	98.2 ± 15.7	97.8 ± 13.2	96.1 ± 15.0	0.490
Fibrinogen (μmol/L)	8.8 (7.7–10.2)	8.6 (7.7–9.9)	9.1 (7.8–10.4)	0.255
FGF19 (pg/mL)	74.1 (59.6–90.1)	122.0 (111.8–143.5)	245.1 (197.6–318.5)	<0.001
Diabetic retinopathy, n (%)	35 (29.4)	23 (19.3)	19 (16.0)	0.032
Use of OHAs, n (%)	77 (64.7)	60 (50.4)	72 (60.5)	0.071
Use of insulin, n (%)	20 (16.8)	17 (14.3)	13 (10.9)	0.423

Notes: Values are expressed as mean ± standard deviation or median (interquartile range). Statistical analysis was performed using the analysis of variance test, Kruskal–Wallis test, or the chi-square test.

Abbreviations: T2DM, type 2 diabetes mellitus; BP, blood pressure; HbA_1c, glycated hemoglobin; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; UACR, urinary albumin-to-creatinine ratio; eGFR, estimated glomerular filtration rate; FGF19, fibroblast growth factor 19; OHAs, oral hypoglycemic agents.

Table 3 Logistic Regression Model of the Association Between FGF19 Level and Diabetic Retinopathy in Patients with T2DM

FGF19^†(pg/mL)		Diabetic Retinopathy
	Odd Ratio	95% Confidence Interval	p-value
Unadjusted	0.75	0.58–0.97	0.030
Model 1	0.70	0.54–0.92	0.010
Model 2	0.69	0.51–0.94	0.019

Notes: ^†Values were logarithmically transformed before the analysis. Model 1: adjusted for age, sex, and body mass index. Model 2: model 1 plus hypertension, fibrinogen^†, hyperlipidemia, glycated hemoglobin, diabetes duration^†, eGFR, UACR^†, and use of insulin and oral hypoglycemic agents.

Abbreviations: FGF19, fibroblast growth factor 19; T2DM, type 2 diabetes mellitus.