Fibroblast growth factor-23 and cardiovascular disease in the general population: the Multi-Ethnic Study of Atherosclerosis.
Fibroblast growth factor-23 and cardiovascular disease in the general population: the Multi-Ethnic Study of Atherosclerosis.
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DOI：
10.1161/circheartfailure.113.000952
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发表时间：
2014-05
期刊：
影响因子：
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通讯作者：
de Boer IH
中科院分区：
文献类型：
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作者：
Kestenbaum B;Sachs MC;Hoofnagle AN;Siscovick DS;Ix JH;Robinson-Cohen C;Lima JA;Polak JF;Blondon M;Ruzinski J;Rock D;de Boer IH
成纤维细胞生长因子-23（FGF-23）是一种磷酸调节激素，在实验模型中直接刺激左心室肥大。FGF-23在一般人群心血管疾病发展中的作用尚不清楚。我们在一个大型前瞻性队列中检测了FGF-23与主要亚临床和临床心血管疾病结局的相关性。我们评估了来自动脉粥样硬化多种族研究（梅萨）的6，547名参与者，他们最初没有心血管疾病。我们使用Kainos免疫测定法测量了血清FGF-23。梅萨通过磁共振成像测量左心室（LV）质量，通过计算机断层扫描测量冠状动脉钙（CAC），通过超声测量颈动脉内膜中层厚度（IMT）。梅萨通过病历审查裁定了心力衰竭、冠心病和斯托克事件。校正后，与最低四分位数相比，最高FGF-23四分位数与估计的2.4 g LV质量增加（95% CI 0.4，4.5）和CAC评分升高的几率增加26%（95% CI 9%至46%）相关。在7.5年的随访中，FGF-23浓度每升高20 pg/mL，心力衰竭风险增加19%（95% CI增加3%至37%），冠心病风险增加14%（95% CI增加1%至28%）。FGF-23与颈动脉IMT或卒中无关。较高的血清FGF-23浓度与亚临床心脏病、新发心力衰竭和冠心病事件相关，但与颈动脉IMT或卒中无关。FGF-23可能是一般人群中新的心血管危险因素。
Fibroblast growth factor-23 (FGF-23) is a phosphate regulatory hormone that directly stimulates left ventricular hypertrophy in experimental models. The role of FGF-23 in cardiovascular disease development in the general population is unclear. We tested associations of FGF-23 with major subclinical and clinical cardiovascular disease outcomes in a large prospective cohort. We evaluated 6,547 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) who were initially free of cardiovascular disease. We measured serum FGF-23 using the Kainos immunoassay. The MESA measured left ventricular (LV) mass by magnetic resonance imaging, coronary calcium (CAC) by computed tomography, and carotid intima-medial thickness (IMT) by ultrasound. The MESA adjudicated incident heart failure, coronary heart disease, and stoke by medical record review. After adjustment, the highest FGF-23 quartile was associated with an estimated 2.4 gram greater LV mass (95% CI 0.4, 4.5 greater) and a 26% greater odds of higher CAC scores (95% CI 9% to 46% greater) compared to the lowest quartile. Over 7.5 years follow-up, each 20-pg/mL higher FGF-23 concentration was associated with a 19% greater risk of heart failure (95% CI 3% to 37% greater) and a 14% greater risk of coronary heart disease (95% CI 1% to 28% greater). FGF-23 was not associated with carotid IMT or stroke. Higher serum FGF-23 concentrations are associated with subclinical cardiac disease and with new heart failure and coronary disease events, but not with carotid IMT or stroke. FGF-23 may be a novel cardiovascular risk factor in the general population.