Association between circulating fibroblast growth factor 23, α-Klotho, and the left ventricular ejection fraction and left ventricular mass in cardiology inpatients.
Association between circulating fibroblast growth factor 23, α-Klotho, and the left ventricular ejection fraction and left ventricular mass in cardiology inpatients.
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DOI：
10.1371/journal.pone.0073184
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Ishizaka N
中科院分区：
文献类型：
--
作者：
Shibata K;Fujita S;Morita H;Okamoto Y;Sohmiya K;Hoshiga M;Ishizaka N
成纤维细胞生长因子23（FGF 23）及其共受体Klotho在磷酸盐代谢中起着至关重要的作用。最近的几项研究表明，循环FGF 23和α-Klotho浓度可能与晚期肾衰竭患者的心血管异常有关。使用100例未接受长期血液透析的心脏病住院患者的数据，分析了循环中FGF 23、α-Klotho和其他钙-磷酸盐代谢相关参数与左心室射血分数（LVEF）和左心室质量（LVM）的相关性。采用改良的Simpson法测量心尖四腔室图像的LVEF，并通过将左室质量除以体表面积计算左室质量指数（LVMI）。单变量分析显示，对数转换的FGF 23（而非α-Klotho）与LVEF和LVMI显著相关，标准化β值分别为-0.35（P<0.001）和0.26（P<0.05）。将年龄、性别、估计肾小球滤过率和血清全段甲状旁腺激素浓度以及25-羟基维生素D作为协变量调整到统计模型中后，发现对数转换的FGF 23是左心室功能下降和左心室肥大的统计学阳性预测因子。在心内科住院患者中，发现循环FGF 23浓度与左心室质量和LVEF相关，而与肾功能和其他钙磷代谢相关参数无关。调节循环FGF 23水平是否会改善如此高风险人群的心脏结局，有待进一步研究。
Fibroblast growth factor 23 (FGF23), with its co-receptor Klotho, plays a crucial role in phosphate metabolism. Several recent studies suggested that circulating FGF23 and α-Klotho concentrations might be related to cardiovascular abnormalities in patients with advanced renal failure. Using data from 100 cardiology inpatients who were not undergoing chronic hemodialysis, the association of circulating levels of FGF23, α-Klotho, and other calcium-phosphate metabolism-related parameters with the left ventricular ejection fraction (LVEF) and left ventricular mass (LVM) was analyzed. LVEF was measured using the modified Simpson method for apical 4-chamber LV images and the LVM index (LVMI) was calculated by dividing the LVM by body surface area. Univariate analysis showed that log transformed FGF23, but not that of α-Klotho, was significantly associated with LVEF and LVMI with a standardized beta of −0.35 (P<0.001) and 0.26 (P<0.05), respectively. After adjusting for age, sex, estimated glomerular filtration rate, and serum concentrations of intact parathyroid hormone, and 25-hydroxyvitamin D as covariates into the statistical model, log-transformed FGF23 was found to be a statistically positive predictor for decreased left ventricular function and left ventricular hypertrophy. In cardiology department inpatients, circulating FGF23 concentrations were found to be associated with the left ventricular mass and LVEF independent of renal function and other calcium-phosphate metabolism-related parameters. Whether modulation of circulating FGF23 levels would improve cardiac outcome in such a high risk population awaits further investigation.
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影响因子：
3.7
作者：
Kitagawa M;Sugiyama H;Morinaga H;Inoue T;Takiue K;Ogawa A;Yamanari T;Kikumoto Y;Uchida HA;Kitamura S;Maeshima Y;Nakamura K;Ito H;Makino H
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