Higher fibroblast growth factor-23 increases the risk of all-cause and cardiovascular mortality in the community
Higher fibroblast growth factor-23 increases the risk of all-cause and cardiovascular mortality in the community
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DOI：
10.1038/ki.2012.327
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发表时间：
2013-01-01
影响因子：
19.6
通讯作者：
Larsson, Tobias E.
中科院分区：
文献类型：
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作者：
Arnlov, Johan;Carlsson, Axel C.;Larsson, Tobias E.
成纤维细胞生长因子-23(FGF23)是一种矿物质代谢调节剂，已被认为与慢性肾脏疾病的心血管疾病有关。由于缺乏关于FGF23与心血管事件纵向关联的社区数据，我们在Uppsala成年男性人群队列纵向研究(平均年龄77岁)的727名男性中调查了可能的关系。在中位数为9.7年的随访期间，110名参与者死于心血管原因。在调整了年龄和已确定的心血管危险因素的COX回归模型中，血清FGF23水平较高与心血管死亡率(危险比(HR)/增加的S.D.)显著增加相关。1.36)。在对肾小球滤过率(GFR)进行调整后，这种关系仍然显著，尽管有所减弱(HR 1.21)。FGF23也与全因死亡率相关，尽管这种关联弱于与心血管死亡率的关联，并且在完全调整的多变量模型中没有显著意义。Spline分析表明，FGF23和结果之间存在对数线性关系。高FGF23(>；60pg/ml)、低GFR(
Fibroblast growth factor-23 (FGF23), a regulator of mineral metabolism, has been linked to cardiovascular disease in chronic kidney disease. As community-based data of the longitudinal association between FGF23 and cardiovascular events are lacking, we investigated a possible relationship in 727 men of the Uppsala Longitudinal Study of Adult Men population-based cohort (mean age 77 years). During a median follow-up of 9.7 years, 110 participants died of cardiovascular causes. In Cox regression models adjusted for age and established cardiovascular risk factors, higher serum FGF23 was associated with a significantly increased risk for cardiovascular mortality (hazard ratio (HR) per increased s.d. of 1.36). This relationship remained significant, albeit attenuated, after adjustment for glomerular filtration rate (GFR) (HR 1.21). FGF23 was also associated with all-cause mortality, although the association was weaker than that with cardiovascular mortality, and it was nonsignificant in fully adjusted multivariate models. Spline analysis suggested a log-linear relationship between FGF23 and outcome. Participants with a combination of high FGF23 (>60 pg/ml), low GFR (