FGF23 is independently associated with vascular calcification but not bone mineral density in patients at various CKD stages

• Published in: Osteoporosis international Vol. 23; no. 7; pp. 2017 - 2025
• Main Authors: Desjardins, L., Liabeuf, S., Renard, C., Lenglet, A., Lemke, H.-D., Choukroun, G., Drueke, T. B., Massy, Z. A.
• Format: Journal Article
• Language: English
• Published: London Springer-Verlag 01.07.2012; Springer Nature B.V; Springer Verlag
• Subjects: Age; Aged; Aorta; Aortic Diseases - blood; Aortic Diseases - etiology; Biomarkers; Biomarkers - blood; Blood Flow Velocity - physiology; Blood vessels; Bone density; Bone Density - physiology; Bone growth; Bone mass; Bone mineral density; Bone turnover; Calcification (ectopic); Calcium; Cohort Studies; Computed tomography; Coronary Disease - blood; Coronary Disease - etiology; Data processing; Dialysis; Endocrinology; Female; Fibroblast growth factor 23; Fibroblast Growth Factors - blood; Fibroblast Growth Factors - physiology; Glomerular Filtration Rate - physiology; Homeostasis; Hormones; Human health and pathology; Humans; Kidney diseases; Kidney Failure, Chronic - blood; Kidney Failure, Chronic - complications; Kidney Failure, Chronic - physiopathology; Life Sciences; Male; Medicine; Medicine & Public Health; Middle Aged; Mineralization; Multidetector Computed Tomography - methods; Original Article; Orthopedics; Osteoporosis; Phosphate; Pulsatile Flow - physiology; Regression analysis; Rheumatology; Severity of Illness Index; Vascular Calcification - blood; Vascular Calcification - etiology; Vascular Stiffness - physiology; Waves; Pulse wave velocity; Vascular calcification; Bone mineral density; Chronic kidney disease; CKD stage; FGF23
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-011-1838-0

Summary The hormone fibroblast growth factor 23 (FGF23) is involved in mineral homeostasis but may also have a role in vascular calcification and bone mineralization. In a cohort of 142 patients with CKD stages 2–5D, plasma FGF23 was independently associated with aortic calcification but not with pulse wave velocity or bone mineral density. Introduction FGF23 is involved in mineral homeostasis but may also have a role in vascular calcification and bone mineralization. Previous studies related to FGF23 and vascular and bone outcomes have been restricted to dialysis patients. The aim of the present study was to establish whether or not plasma FGF23 is associated with aortic and coronary calcification, arterial stiffness, and bone mineral density in patients with early as well as late stages of CKD. Methods In a cohort of 142 patients with CKD stages 2–5D, we made routine biochemistry and intact FGF23 determinations, and assessed aortic and coronary calcification, bone mineral density (BMD), and arterial stiffness by multislice spiral computed tomography and automated pulse wave velocity (PWV). Results Plasma intact FGF23 levels were elevated in CKD patients; the elevation preceded that of serum phosphate in early-stage CKD. Patients with elevated FGF23 levels had higher aortic and coronary calcification scores than patients with lower FGF23 levels. Multivariate linear regression analysis indicated that only age ( p  < 0.001) and FGF23 ( p  = 0.008) were independently associated with aortic calcification score. Plasma FGF23 was neither associated with PWV nor with BMD. Conclusion Our data suggest that plasma FGF23 is an independent biomarker of vascular calcification in patients with various CKD stages including early stages. The association between vascular calcification and FGF23 levels appears to be independent of BMD. It remains to be seen whether this association is independent of bone turnover and bone mass.