Time-updated Fibroblast Growth Factor 23 Is Predictive for Posttransplant Diabetes Mellitus in Kidney Transplant Recipients

Amarens van der Vaart; Daan Kremer; Tessa Niekolaas; Stephan J L Bakker; Peter R van Dijk; Martin H de Borst

doi:10.1210/jendso/bvae055

Time-updated Fibroblast Growth Factor 23 Is Predictive for Posttransplant Diabetes Mellitus in Kidney Transplant Recipients

J Endocr Soc. 2024 Apr 4;8(5):bvae055. doi: 10.1210/jendso/bvae055. eCollection 2024 Mar 12.

Authors

Amarens van der Vaart^{1

2}, Daan Kremer¹, Tessa Niekolaas¹, Stephan J L Bakker¹, Peter R van Dijk², Martin H de Borst¹

Affiliations

¹ Department of Internal Medicine, Divisions of Nephrology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, the Netherlands.
² Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, 9700 RB Groningen, the Netherlands.

Abstract

Objective: This work aimed to study whether fibroblast growth factor 23 (FGF23) is predictive for incident posttransplant diabetes mellitus (PTDM) in kidney transplant recipients (KTRs).

Methods: We repeatedly analyzed plasma C-terminal FGF23 concentrations in 170 KTRs enrolled in the TransplantLines Biobank and Cohort Study. Associations of time-updated plasma FGF23 with incident PTDM were studied by Cox regression.

Results: A total of 170 KTRs (46% female, aged 54.4 ± 12.4 years) with 540 FGF23 measurements were included. Plasma FGF23 concentrations at transplantation were 31.1 (0.76-2576) pmol/L. During a follow-up of 24 (12-24) months, 38 patients developed PTDM. The highest FGF23 tertile (compared to the lowest) was associated with an increased risk for PTDM (fully adjusted hazard ratio 20.9; 95% CI, 3.4-130.0; P < .001).

Conclusion: In KTRs without diabetes at baseline, the highest tertile of FGF23, compared to the lowest, is predictive for development of PTDM.

Keywords: fibroblast growth factor 23; kidney transplant recipients; post-transplant diabetes mellitus.