Interrelationship between Serum Osteopontin and FGF-23 Levels with Carotid Artery Calcification among Diabetic Patients

Abstract

Background: Carotid artery calcification (CAC) is a recognized marker of vascular complications in type 2 diabetes mellitus (T2DM). Osteopontin (OPN) and fibroblast growth factor-23 (FGF-23) are key regulators of mineral metabolism and vascular function, but their specific contributions in newly diagnosed T2DM are not fully established.

Aims: This study aimed to investigate the interrelationship between serum OPN and FGF-23 levels and the presence of carotid artery calcification in patients with recent-onset T2DM.

Methods: A total of 86 participants were enrolled, including 45 patients with newly diagnosed T2DM (Group A) and 41 age- and sex-matched healthy controls (Group B). Biochemical parameters, including fasting serum glucose and glycated hemoglobin (HbA1c), were measured. Serum OPN and FGF-23 concentrations were quantified using immunoassays, while carotid ultrasonography was used to detect and characterize vascular calcification.

Results: Compared with controls, patients in Group A showed significantly higher fasting glucose, HbA1c, and serum FGF-23 levels, while OPN concentrations were significantly lower (p < 0.05). OPN exhibited a negative correlation with fasting glucose and HbA1c, suggesting that reduced OPN may reflect poorer glycemic control. In contrast, elevated FGF-23 was strongly associated with the presence of carotid artery calcification in diabetic patients, independent of renal function, highlighting its specific role in vascular pathology.

Conclusion: In newly diagnosed T2DM, OPN appears linked primarily to glycemic regulation, whereas FGF-23 is more directly associated with vascular calcification. FGF-23 may therefore serve as a potential early biomarker for vascular risk stratification in diabetic patients.