Fibroblast growth factor-23 and death, heart failure, and cardiovascular events in community-living individuals: CHS (Cardiovascular Health Study).
Fibroblast growth factor-23 and death, heart failure, and cardiovascular events in community-living individuals: CHS (Cardiovascular Health Study).
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DOI：
10.1016/j.jacc.2012.03.040
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发表时间：
2012-07-17
影响因子：
24
通讯作者：
Shlipak, Michael G.
中科院分区：
文献类型：
--
作者：
Ix, Joachim H.;Katz, Ronit;Kestenbaum, Bryan R.;de Boer, Ian H.;Chonchol, Michel;Mukamal, Kenneth J.;Rifkin, Dena;Siscovick, David S.;Sarnak, Mark J.;Shlipak, Michael G.
关键词：
确定FGF23与死亡、心衰和CVD的关系，并研究CKD在普通社区生活人群中的影响。FGF23增加肾磷排泄，抑制维生素D激活。在终末期肾病中，高FGF23水平与死亡率相关。在普通人群中，FGF23与死亡、心力衰竭（HF）和心血管疾病（CVD）的关系尚不清楚。1996 - 1997年对3107名≥65岁的社区居民进行血浆FGF23测量，随访至2008年。HF和CVD事件由专家小组裁决。使用Cox比例风险模型评估FGF23与各结局的关联，并检验CKD状态是否存在关联差异。较低的eGFR和较高的尿ACR与基线时较高的FGF23相关。在10.5年（中位）随访期间，有1730例死亡，697例心衰事件和797例心血管疾病事件。尽管在综合分析中，高FGF23浓度与每个结果相关，但CKD患者的相关性始终更强（相互作用P均< 0.006）。在CKD组（n= 1128）中，与最低四分位数相比，FGF23最高四分位数的全因死亡校正危险比（HR）为1.87(1.47,2.38)，心衰发生率为1.94(1.32,2.83)，心血管事件发生率为1.49（1.02,2.18）。无CKD组（n= 1979）相应的hr分别为1.29（1.05,1.59）、1.37（0.99,1.89）和1.07（0.79,1.45）。FGF23是一种参与磷和维生素D稳态的激素，与社区生活老年人的全因死亡和心衰事件独立相关。这些关联在CKD患者中表现得更强。
To determine the associations of FGF23 with death, HF, and CVD and investigate the influence of CKD in a general community-living population. FGF23 increases renal phosphorus excretion and inhibits vitamin D activation. In ESRD, high FGF23 levels are associated with mortality. The associations of FGF23 with death, heart failure (HF), and cardiovascular disease (CVD) in teh general population are unknown. Plasma FGF23 was measured in 3,107 community-living persons ≥ 65 years in 1996–97, and participants were followed through 2008. HF and CVD events were adjudicated by a panel of experts. Associations of FGF23 with each outcome were evaluated using Cox proportional hazards models, and we tested whether associations differed by CKD status. Both lower eGFR and higher urine ACR were associated with high FGF23 at baseline. During 10.5 years (median) follow-up, there were 1,730 deaths, 697 incident HF events, and 797 incident CVD events. Although high FGF23 concentrations were associated with each outcome in combined analyses, the associations were consistently stronger for those with CKD (P interactions all < 0.006). In the CKD group (n=1,128), the highest FGF23 quartile had adjusted hazards ratios (HR) of 1.87 (1.47, 2.38) for all-cause death, 1.94 (1.32, 2.83) for incident HF, and 1.49 (1.02, 2.18) for incident CVD events compared to the lowest quartile. Corresponding HRs in those without CKD (n=1,979) were 1.29 (1.05, 1.59), 1.37 (0.99, 1.89), and 1.07 (0.79, 1.45). FGF23, a hormone involved in phosphorous and vitamin D homeostasis, is independently associated with all-cause death and incident HF in community-living older persons. These associations appear stronger in persons with CKD.
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DOI：
10.1056/nejmoa0706130
发表时间：
2008-08-07
期刊：
The New England journal of medicine
影响因子：
--
作者：
Gutiérrez OM;Mannstadt M;Isakova T;Rauh-Hain JA;Tamez H;Shah A;Smith K;Lee H;Thadhani R;Jüppner H;Wolf M
通讯作者：
Wolf M
影响因子：
37.8
作者：
Cushman, M;Arnold, AM;Tracy, RP
通讯作者：
Tracy, RP
影响因子：
4.8
作者：
Foley, Robert N.;Collins, Allan J.;Kalra, Philip A.
通讯作者：
Kalra, Philip A.
影响因子：
37.8
作者：
Bibbins-Domingo, K;Lin, F;Shlipak, MG
通讯作者：
Shlipak, MG
影响因子：
39.2
作者：
Parker BD;Schurgers LJ;Brandenburg VM;Christenson RH;Vermeer C;Ketteler M;Shlipak MG;Whooley MA;Ix JH
通讯作者：
Ix JH