Fibroblast growth factor 23, left ventricular mass,and left ventricular hypertrophy in community-dwelling older adults |
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| Authors: | Anna Jovanovich Joachim H. Ix John Gottdiener Kim McFann Ronit Katz Bryan Kestenbaum Ian H. de Boer Mark Sarnak Michael G. Shlipak Kenneth J. Mukamal David Siscovick Michel Chonchol |
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| Affiliation: | 1. Division of Renal Diseases and Hypertension, University of Colorado Denver, Mail Stop C281, 12700 E. 19th Ave, Room 7C03-A, Aurora, CO 80045, USA;2. Nephrology Section, Veterans Affairs San Diego Healthcare System, 3359 La Jolla Village Dr., Mail code 111-H, San Diego, CA 91261, USA;3. Division of Nephrology and Hypertension, Department of Medicine, University of California San Diego, 3359 La Jolla Village Dr., Mail code 111-H, San Diego, CA 91261, USA;4. Division of Preventive Medicine, Departments of Family and Preventive Medicine and Medicine, University of California San Diego, 3359 La Jolla Village Dr., Mail code 111-H, San Diego, CA 91261, USA;5. Division of Cardiology, University of Maryland, 22 S. Greene Street, Baltimore, MD 21201, USA;6. Division of Nephrology and Kidney Research Institute, University of Washington, 908 Jefferson St., 3rd Floor, Office 3NJ350, Seattle, WA 98104, USA;g Division of Nephrology, 800 Washington Street, Tufts Medical Center #391, Boston, MA 02111, USA;h General Internal Medicine Section, Veterans Affairs Medical Center, University of California, 4150 Clement St., San Francisco, CA 94121, USA;i Department of Medicine, Beth Israel Deaconess Medical Center, 1000 Broadway, Chelsea, MA 02150, USA;j Cardiovascular Health Research Unit, Departments of Medicine and Epidemiology, University of Washington, 1730 Minor Ave, Seattle, WA 98101, USA |
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| Abstract: | ObjectivesIn chronic kidney disease (CKD), high FGF23 concentrations are associated with left ventricular hypertrophy (LVH), cardiovascular events, and death. The associations of FGF23 with left ventricular mass (LVM) and LVH in the general population and the influence of CKD remains uncertain.MethodsC-terminal plasma FGF23 concentrations were measured, and LVM and LVH evaluated by echocardiogram among 2255 individuals ≥65 years in the Cardiovascular Health Study. Linear regression analysis adjusting for demographics, cardiovascular, and kidney related risk factors examined the associations of FGF23 concentrations with LVM. Analyses were stratified by CKD status and adjusted linear and logistic regression analysis explored the associations of FGF23 with LVM and LVH.ResultsAmong the entire cohort, higher FGF23 concentrations were associated with greater LVM in adjusted analyses (β = 6.71 [95% CI 4.35–9.01] g per doubling of FGF23). 32% (n = 624) had CKD (eGFR <60 mL/min/1.73 m2 and/or urine albumin-to-creatinine ratio >30 mg/g). Associations were stronger among participants with CKD (p interaction = 0.006): LVM β = 9.71 [95% CI 5.86–13.56] g per doubling of FGF23 compared to those without CKD (β = 3.44 [95% CI 0.77, 6.11] g per doubling of FGF23). While there was no significant interaction between FGF23 and CKD for LVH (p interaction = 0.25), the OR (1.46 95% CI [1.20–1.77]) in the CKD group was statistically significant and of larger magnitude than the OR for in the no CKD group (1.12 [95% CI 0.97–1.48]).ConclusionIn a large cohort of older community-dwelling adults, higher FGF23 concentrations were associated with greater LVM and LVH with stronger relationships in participants with CKD. |
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| Keywords: | Left ventricular mass Left ventricular hypertrophy Chronic kidney disease Fibroblast growth factor 23 Older adults Cardiovascular disease |
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