Sørensen MH, Bojer AS, Jørgensen NR, et al. - Researchers conducted this cross-sectional study to explore the connection between fibroblast growth factor-23 (FGF-23) and cardiac structure, function and perfusion in patients with type 2 diabetes and normal or mildly impaired kidney function, as well as to analyze the link between FGF-23, anti-diabetes therapy and the classic complications and risk factors related to type 2 diabetes. Two hundred forty-six patients with type 2 diabetes underwent echocardiography and advanced cardiac MRI to evaluate left ventricular structure and function. Myocardial blood flow (MBF) during rest and pharmacological stress (adenosine 140 µg/kg/min) were also assessed in 183 of the patients. Patients with eGFR < 60 ml/min/1.73 m² have been excluded. Elevated levels of FGF-23 are correlated with impaired cardiac diastolic function and reduced MPR in patients with type 2 diabetes and normal or mildly impaired kidney function, caused by a reduction in maximal MBF during stress. Decreased levels of FGF-23 are correlated with the use of GLP-1 analogues.