Relationship between circulating FGF23 and total body atherosclerosis in the community

• Published in: Nephrology, dialysis, transplantation Vol. 24; no. 10; pp. 3125 - 3131
• Main Authors: Mirza, Majd A. I., Hansen, Tomas, Johansson, Lars, Ahlström, Håkan, Larsson, Anders, Lind, Lars, Larsson, Tobias E.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.10.2009
• Subjects: Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; atherosclerosis; Atherosclerosis - blood; Biological and medical sciences; calcification; chronic kidney disease; Emergency and intensive care: renal failure. Dialysis management; Female; FGF23; Fibroblast Growth Factors - blood; Humans; Intensive care medicine; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; MEDICIN; MEDICINE; Miscellaneous. Technology; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; phosphate; atherosclerosis; phosphate; chronic kidney disease; calcification; FGF23; Kidney disease; Phosphates; Urinary system disease; Hemodialysis; Cardiovascular disease; Vascular disease; Extrarenal dialysis; Atherosclerosis; Renal failure; Calcification
• ISSN: 0931-0509; 1460-2385; 1460-2385
• DOI: 10.1093/ndt/gfp205

Background. Fibroblast growth factor-23 (FGF23) is a regulator of mineral metabolism and has been suggested to play a role in vascular calcification in chronic kidney disease (CKD). Data on the association between FGF23 and atherosclerosis, both in CKD and in the community, is limited. Methods. The total body atherosclerosis score (AS) was determined by a magnetic resonance imaging-based angiography in 306 elderly men and women, representing a subsample of the community-based PIVUS cohort. Subjects were divided into three categories based on AS: AS = 0, low AS and high AS. Serum FGF23 was measured using a two-site monoclonal antibody ELISA. Results. In continuous and multi-category regression models, higher FGF23 was associated with a significant increase in the odds of having a high AS (OR 1.43, CI 1.06–1.92 to OR 3.01, CI 1.52–5.99). This association was stronger in individuals with eGFR <60 mL/min/1.73 m2 (n = 27), reaching a nearly 6-fold increase in the odds for a high AS in the upper FGF23 tertile (OR 5.64, CI 2.78–11.5). We found weaker support for a relationship between FGF23 and the presence of atherosclerosis as subjects in the highest FGF23 tertile had an increased risk for an AS > 0 in crude models (OR 1.93, CI 1.05–3.55), but this was not statistically significant in adjusted (OR 1.42, CI 0.74–1.72) models. Conclusions. We provide novel evidence supporting an association between serum FGF23 and total body atherosclerosis in the community. Additional studies are warranted to determine the prospective relationship between FGF23 and atherosclerosis, and whether FGF23 is a modifiable cardiovascular risk factor.