Document Detail

Fibroblast growth factor 23 and left ventricular hypertrophy in chronic kidney disease.
MedLine Citation:
PMID:  19414634     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Fibroblast growth factor 23 (FGF-23) is a phosphorus-regulating hormone. In chronic kidney disease (CKD), circulating FGF-23 levels are markedly elevated and independently associated with mortality. Left ventricular hypertrophy and coronary artery calcification are potent risk factors for mortality in CKD, and FGFs have been implicated in the pathogenesis of both myocardial hypertrophy and atherosclerosis. We conducted a cross-sectional study to test the hypothesis that elevated FGF-23 concentrations are associated with left ventricular hypertrophy and coronary artery calcification in patients with CKD.
METHODS AND RESULTS: In this study, 162 subjects with CKD underwent echocardiograms and computed tomography scans to assess left ventricular mass index and coronary artery calcification; echocardiograms also were obtained in 58 subjects without CKD. In multivariable-adjusted regression analyses in the overall sample, increased log FGF-23 concentrations were independently associated with increased left ventricular mass index (5% increase per 1-SD increase in log FGF-23; P=0.01) and risk of left ventricular hypertrophy (odds ratio per 1-SD increase in log FGF-23, 2.1; 95% confidence interval, 1.03 to 4.2). These associations strengthened in analyses restricted to the CKD subjects (11% increase in left ventricular mass index per 1-SD increase in log FGF-23; P=0.01; odds ratio of left ventricular hypertrophy per 1-SD increase in log FGF-23, 2.3; 95% confidence interval, 1.2 to 4.2). Although the highest tertile of FGF-23 was associated with a 2.4-fold increased risk of coronary artery calcification > or =100 versus <100 U compared with the lowest tertile (95% confidence interval, 1.1 to 5.5), the association was no longer significant after multivariable adjustment.
CONCLUSIONS: FGF-23 is independently associated with left ventricular mass index and left ventricular hypertrophy in patients with CKD. Whether increased FGF-23 is a marker or a potential mechanism of myocardial hypertrophy in CKD requires further study.
Orlando M Gutiérrez; James L Januzzi; Tamara Isakova; Karen Laliberte; Kelsey Smith; Gina Collerone; Ammar Sarwar; Udo Hoffmann; Erin Coglianese; Robert Christenson; Thomas J Wang; Christopher deFilippi; Myles Wolf
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2009-05-04
Journal Detail:
Title:  Circulation     Volume:  119     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-19     Completed Date:  2009-06-05     Revised Date:  2013-06-17    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2545-52     Citation Subset:  AIM; IM    
Division of Nephrology and Hypertension, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
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MeSH Terms
C-Reactive Protein / analysis
Calcinosis / blood*,  complications
Chronic Disease
Coronary Occlusion / blood*,  complications,  radiography
Cross-Sectional Studies
Diabetes Mellitus / blood
Fibroblast Growth Factors / blood*
Glomerular Filtration Rate
Hypertension / blood
Hypertrophy, Left Ventricular / blood*,  complications,  pathology,  ultrasonography
Kidney Diseases / blood*,  complications,  physiopathology
Middle Aged
Natriuretic Peptide, Brain / blood
Obesity / blood
Phosphates / blood
Single-Blind Method
Vitamin D / blood
Grant Support
K23 DK081673/DK/NIDDK NIH HHS; K23 DK081673-01/DK/NIDDK NIH HHS; K23 RR017376/RR/NCRR NIH HHS; K23 RR017376-05/RR/NCRR NIH HHS; K23DK081673/DK/NIDDK NIH HHS; K23RR017376/RR/NCRR NIH HHS; K30 RR022292-07/RR/NCRR NIH HHS; K30RR02229207/RR/NCRR NIH HHS; M01RR01066/RR/NCRR NIH HHS; R01 DK076116-02/DK/NIDDK NIH HHS; R01 DK076116-05/DK/NIDDK NIH HHS; R01 HL086875-02/HL/NHLBI NIH HHS; R01DK076116/DK/NIDDK NIH HHS; R01HL086875/HL/NHLBI NIH HHS
Reg. No./Substance:
0/Phosphates; 0/fibroblast growth factor 23; 114471-18-0/Natriuretic Peptide, Brain; 1406-16-2/Vitamin D; 62031-54-3/Fibroblast Growth Factors; 9007-41-4/C-Reactive Protein

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