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Fibroblast Growth Factor 23 and the Risk of Infection-Related Hospitalization in Older Adults.
Tuesday,2017-05-02 16:06 America/Los_Angeles — ecterry
| Title | Fibroblast Growth Factor 23 and the Risk of Infection-Related Hospitalization in Older Adults. |
| Publication Type | Journal Article |
| Year of Publication | 2017 |
| Authors | Nowak, KL, Bartz, TM, Dalrymple, L, de Boer, IH, Kestenbaum, B, Shlipak, MG, Garimella, PS, Ix, JH, Chonchol, M |
| Journal | J Am Soc Nephrol |
| Volume | 28 |
| Issue | 4 |
| Pagination | 1239-1246 |
| Date Published | 2017 Apr |
| ISSN | 1533-3450 |
| Abstract | <p>Within monocytes, 1,25-dihydroxyvitamin D [1,25(OH)2D] is important for production of cathelicidins, which in turn, are critical for antibacterial action. Fibroblast growth factor 23 (FGF23) decreases 1,25(OH)2D production and thus, could increase infection risk. We examined this possibility in 3141 community-dwelling adults ages ≥65 years old at baseline in the Cardiovascular Health Study using Cox proportional hazards models to examine the association between FGF23 concentrations and first infection-related hospitalizations and determine whether associations differed by the presence of CKD (eGFR<60 ml/min per 1.73 m(2) [n=832] or urine albumin-to-creatinine ratio >30 mg/g [n=577]). Mean±SD age of participants was 78±5 years old, 60% of participants were women, and the median plasma FGF23 concentration was 70 (interquartile range, 53-99) relative units per milliliter. In fully adjusted models, higher FGF23 concentrations associated with higher risk of first infection-related hospitalization (hazard ratio [HR], 1.11; 95% confidence interval [95% CI], 1.03 to 1.20 per doubling of FGF23) during a median follow-up of 8.6 years. In participants with or without CKD (defined by eGFR), FGF23 concentration associated with first infection-related hospitalization with HRs of 1.24 (95% CI, 1.08 to 1.42) and 1.06 (95% CI, 0.97 to 1.17) per doubling of FGF23, respectively (P=0.13 for interaction). Associations did not differ between groups when stratified by urine albumin-to-creatinine ratio. In sensitivity analyses, the addition of serum calcium, phosphorus, 25-hydroxyvitamin D, intact parathyroid hormone, and 24,25-dihydroxyvitamin D did not meaningfully change the estimates. In conclusion, in community-dwelling older adults, higher plasma FGF23 concentrations independently associated with the risk of first infection-related hospitalization.</p> |
| DOI | 10.1681/ASN.2016040401 |
| Alternate Journal | J. Am. Soc. Nephrol. |
| PubMed ID | 28122946 |
| PubMed Central ID | PMC5373449 |
| Grant List | U01 HL080295 / HL / NHLBI NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States R01 HL094555 / HL / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States K01 DK103678 / DK / NIDDK NIH HHS / United States HHSN268201200036C / HL / NHLBI NIH HHS / United States R01 HL080295 / HL / NHLBI NIH HHS / United States N01HC85082 / HL / NHLBI NIH HHS / United States N01HC85083 / HL / NHLBI NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States N01HC85080 / HL / NHLBI NIH HHS / United States R56 AG023629 / AG / NIA NIH HHS / United States N01HC85081 / HL / NHLBI NIH HHS / United States |
ePub date:
17/04