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Correlation between the ratio of fibroblast growth factor 21 to Klotho with the incidence and severity of diabetic retinopathy in type 2 diabetes mellitus patients
Basir H.
Gazzetta Medica Italiana Archivio Per Le Scienze Mediche
Q4Abstract
BACKGROUND: Diabetes mellitus (DM) is a chronic metabolic disorder characterized by increased blood sugar levels due to impaired insulin secretion, insulin action, or a combination of both. Diabetic retinopathy affects 50-60% of individuals with DM, leading to blindness in 2.6% of cases. In diabetic retinopathy, FGF21 levels increase while Klotho levels decrease, resulting in a higher ratio of FGF21 levels to serum Klotho levels.METHODS: This cross-sectional study was conducted at Wahidin Sudirohusodo Hospital and Hasanuddin University Teaching Hospital in Makassar from December 2023 until January 2024. The study included type 2 DM patients aged over 18 years. The analysis used descriptive methods and statistical tests, considering results significant if the P<0.05.RESULTS: The study included 88 patients with diabetes with an average age of 52.41±11.32 years old. Of these, 39 subjects (44.3%) had no retinopathy, 24 subjects (27.3%) had nonproliferative diabetic retinopathy, and 25 subjects (28.4%) had proliferative diabetic retinopathy. There was a significant correlation between increased serum FGF21 levels and the incidence and severity of diabetic retinopathy (P=0.005). The optimal cut-off point for the ratio of serum FGF21 levels to serum Klotho levels with the incidence and severity of diabetic retinopathy was found to be 4.1 (P=0.009; OR 3.24, 95% CI 1.3-8.01).CONCLUSIONS: This study discovered a correlation between a high ratio of serum FGF21 levels to serum Klotho levels and the incidence and severity of diabetic retinopathy in patients with type 2 DM.