Evidence mapPaperPMID 40205169Full record

ArticleGeroScience2025

Association of Klotho and FGF23 with cardiovascular outcomes in diabetic older adults with chronic limb-threatening ischemia: a prospective study.

Federico Biscetti, Silvia Giovannini, Roberto Iezzi, Claudia Loreti, Pietro Caliandro, Lorenzo Biscotti, Dario Pitocco, Andrea Flex

Abstract read
In one paragraph

Article in GeroScience, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Federico BiscettiDepartment of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168, Rome, Italy.
Silvia GiovanniniDepartment of Geriatrics and Orthopaedics, Università Cattolica del Sacro Cuore, L.Go Francesco Vito 1, 00168, Rome, Italy. silvia_giovannini@yahoo.it.ORCID 0000-0001-9125-752X
Roberto IezziDepartment of Radiological and Hematological Sciences, Università Cattolica del Sacro Cuore, 00168, Rome, Italy.
Claudia LoretiDepartment of Emergency, Anaesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy.
Pietro CaliandroDepartment of Neurosciences, Università Cattolica del Sacro Cuore, 00168, Rome, Italy.
Lorenzo BiscottiDepartments Administrative Support Unit, University, Università Cattolica del Sacro Cuore, 00168, Rome, Italy.
Dario PitoccoCardiovascular Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168, Rome, Italy.
Andrea FlexDepartment of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, 00168, Rome, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Peripheral arterial disease (PAD) is more prevalent in individuals with type 2 diabetes mellitus (T2DM). The most severe complication of PAD is chronic limb-threatening ischemia (CLTI), which is associated with major adverse cardiovascular events (MACE) and major adverse limb events (MALE) following lower limb revascularization (LER). This study investigates the relationship between baseline levels of Klotho and FGF23 and the risk of cardiovascular and limb-related outcomes after LER in a selected cohort of older adults. The study enrolled 109 older patients with PAD and CLTI requiring LER. Baseline levels of Klotho and FGF23 were measured, and their associations with subsequent MACE and MALE were analyzed over a 12-month follow-up period. Using stepwise multivariable logistic regression and Cox proportional hazards models, we found that among 109 older patients with PAD and CLTI undergoing LER, independent predictors of MACE included age (p = 0.016), male sex (p = 0.006), BMI (p = 0.004), diabetes duration (p = 0.031), hypertension (p = 0.013), and smoking status (p < 0.001), with higher FGF23 (p < 0.001) and lower Klotho levels (p = 0.002) significantly associated with increased risk; in the Cox model, increased Klotho was linked to a reduced risk of MACE (95% CI: 0.994-1.000, p = 0.022), while multivariate analysis for MALE confirmed Klotho as an independent predictor (p < 0.01). These findings reinforce the hypothesis that altered baseline levels of Klotho, and FGF23 are associated with adverse cardiovascular and limb outcomes in diabetic individuals over 75 years old with PAD and CLTI, highlighting their potential role as biomarkers for post-revascularization risk stratification.

Indexed as

Chronic Limb-Threatening IschemiaDiabetes Mellitus, Type 2Fibroblast Growth FactorsGlucuronidaseIschemiaPeripheral Arterial DiseaseAgedAged, 80 and overBiomarkersCardiovascular DiseasesFemaleFibroblast Growth Factor-23HumansKlotho ProteinsMaleProportional Hazards ModelsBiomarkersFGF23 protein, humanFibroblast Growth Factor-23Fibroblast Growth FactorsGlucuronidaseKlotho ProteinsKL protein, humanAgingCardiovascular outcomesChronic limb-threatening ischemiaDiabetesFGF23Klotho

Identifiers

PMID40205169
PMCPMC12181444

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.