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Fibroblast growth factor 23, the ankle-brachial index, and incident peripheral artery disease in the Cardiovascular Health Study.
Tuesday,2014-02-25 12:02 America/Los_Angeles — poolea2
| Title | Fibroblast growth factor 23, the ankle-brachial index, and incident peripheral artery disease in the Cardiovascular Health Study. |
| Publication Type | Journal Article |
| Year of Publication | 2014 |
| Authors | Garimella, PS, Ix, JH, Katz, R, Chonchol, MB, Kestenbaum, BR, de Boer, IH, Siscovick, DS, Shastri, S, Hiramoto, JS, Shlipak, MG, Sarnak, MJ |
| Journal | Atherosclerosis |
| Volume | 233 |
| Issue | 1 |
| Pagination | 91-6 |
| Date Published | 2014 Mar |
| ISSN | 1879-1484 |
| Keywords | Aged, Ankle Brachial Index, Cardiovascular Diseases, Cross-Sectional Studies, Fibroblast Growth Factors, Humans, Incidence, Peripheral Arterial Disease, Risk Factors |
| Abstract | <p><b>BACKGROUND: </b>Fibroblast growth factor 23 (FGF23) has emerged as a novel risk factor for mortality and cardiovascular events. Its association with the ankle-brachial index (ABI) and clinical peripheral artery disease (PAD) is less known.</p><p><b>METHODS: </b>Using data (N = 3143) from the Cardiovascular Health Study (CHS), a cohort of community dwelling adults >65 years of age, we analyzed the cross-sectional association of FGF23 with ABI and its association with incident clinical PAD events during 9.8 years of follow up using multinomial logistic regression and Cox proportional hazards models respectively.</p><p><b>RESULTS: </b>The prevalence of cardiovascular disease (CVD) and traditional risk factors like diabetes, coronary artery disease, and heart failure increased across higher quartiles of FGF23. Compared to those with ABI of 1.1-1.4, FGF23 per doubling at baseline was associated with prevalent PAD (ABI < 0.9) although this association was attenuated after adjusting for CVD risk factors, and kidney function (OR 0.91, 95% CI 0.76-1.08). FGF23 was not associated with high ABI (>1.4) (OR 1.06, 95% CI 0.75-1.51). Higher FGF23 was associated with incidence of PAD events in unadjusted, demographic adjusted, and CVD risk factor adjusted models (HR 2.26, 95% CI 1.28-3.98; highest versus lowest quartile). The addition of estimated glomerular filtration and urine albumin to creatinine ratio to the model however, attenuated these findings (HR 1.46, 95% CI, 0.79-2.70).</p><p><b>CONCLUSIONS: </b>In community dwelling older adults, FGF23 was not associated with baseline low or high ABI or incident PAD events after adjusting for confounding variables. These results suggest that FGF23 may primarily be associated with adverse cardiovascular outcomes through non atherosclerotic mechanisms.</p> |
| DOI | 10.1016/j.atherosclerosis.2013.12.015 |
| Alternate Journal | Atherosclerosis |
| PubMed ID | 24529128 |
| PubMed Central ID | PMC3927151 |
| Grant List | N01HC85080 / HC / NHLBI NIH HHS / United States HHSN268200800007C / HL / NHLBI NIH HHS / United States R01HL094555 / HL / NHLBI NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States K24 DK078204 / DK / NIDDK NIH HHS / United States N01HC85081 / HC / NHLBI NIH HHS / United States N01HC85079 / HC / NHLBI NIH HHS / United States HHSN268201200036C / HL / NHLBI NIH HHS / United States N01HC85086 / HC / NHLBI NIH HHS / United States N01HC85082 / HC / NHLBI NIH HHS / United States R01 AG027002 / AG / NIA NIH HHS / United States HHSN268200800007C / / PHS HHS / United States HHSN268201200036C / / PHS HHS / United States HL080295 / HL / NHLBI NIH HHS / United States N01HC85083 / HC / NHLBI NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States AG023629 / AG / NIA NIH HHS / United States AG 027002 / AG / NIA NIH HHS / United States N01 HC55222 / HC / NHLBI NIH HHS / United States |