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Circulating fibroblast growth factor 23 is associated with angiographic severity and extent of coronary artery disease.

Xiao Y, Peng C, Huang W, Zhang J, Xia M, Zhang Y, Ling W - PLoS ONE (2013)

Bottom Line: Fibroblast growth factor 23 (FGF23) is a circulating regulator of phosphate and vitamin D metabolism and is associated with coronary artery calcification, and has been implicated in the pathogenesis of cardiovascular disease.Furthermore, subgroup analyses found FGF23 was significantly associated with plaque and dense calcium volumes.Multiple logistic regression analyses showed that serum FGF23 levels were significantly independent predictors of TVR and TLR.

View Article: PubMed Central - PubMed

Affiliation: Department of Nutrition and Food Hygiene, Shenzhen Centre for Disease Control and Prevention, Shenzhen, Guangdong, China ; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, Guangdong, China ; Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China.

ABSTRACT

Objective: Fibroblast growth factor 23 (FGF23) is a circulating regulator of phosphate and vitamin D metabolism and is associated with coronary artery calcification, and has been implicated in the pathogenesis of cardiovascular disease. The aim of this study was to determine whether circulating FGF23 concentration is independently associated with the severity and extent of coronary artery disease in patients undergoing coronary angiography.

Method: A cross-sectional design was used to examine the relationship between serum FGF23 and the severity and extent of coronary artery stenosis in 2076 patients undergoing coronary angiography (1263 male and 813 female, mean aged 62.5 years). Subgroup analyses were performed to assess the associations between FGF23 and coronary arterial plaque characteristics evaluated by intravascular ultrasound and 12-month incidence of target vessel revascularization (TVR) and target lesion revascularization (TLR).

Findings: We found a stepwise increase of serum FGF23 concentrations in patients with mild, moderate, severe stenosis or with increased number of stenotic vessels compared with those without stenosis (P<0.001). Serum FGF23 concentration was positively correlated with stenosis scores as the global index of the severity and extent of coronary artery stenosis in both male and female (r = 0.315 and r = 0.291, P<0.001). In multiple regression analyses, serum FGF23 concentration was a significant determinant of the stenosis scores independent of other traditional risk factors (standardized β = 0.326, P<0.001). Furthermore, subgroup analyses found FGF23 was significantly associated with plaque and dense calcium volumes. Multiple logistic regression analyses showed that serum FGF23 levels were significantly independent predictors of TVR and TLR.

Conclusions: We report an independent association between circulating FGF23 concentration and the severity and extent of coronary artery stenosis in the coronary angiographic patients. Future studies are needed to elucidate the potential biological mechanisms and whether FGF23 is a modifiable cardiovascular risk factor.

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Box plots showing circulating FGF23 concentrations by angiographic extent of coronary artery disease.A. Severity of coronary artery stenosis. B. Number of stenosis vessels. Horizontal lines show median, 25th to 75th percentiles (boxes), and 10th to 90th percentiles (whiskers). FGF23 = Fibroblast growth factor 23, VD = vessel disease.
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pone-0072545-g001: Box plots showing circulating FGF23 concentrations by angiographic extent of coronary artery disease.A. Severity of coronary artery stenosis. B. Number of stenosis vessels. Horizontal lines show median, 25th to 75th percentiles (boxes), and 10th to 90th percentiles (whiskers). FGF23 = Fibroblast growth factor 23, VD = vessel disease.

Mentions: To explore the relationship between serum FGF23 concentration and the severity and extent of CAD, we found a stepwise increase of serum FGF23 concentrations in patients with mild (median, 42.3 pg/mL; IQR, 38.9 to 46.9 pg/mL), moderate (median, 44.5 pg/mL; IQR, 41.1 to 53.7 pg/mL), severe stenosis (median, 50.6 pg/mL, IQR, 46.4 to 74.1 pg/mL) compared with those without stenosis (median, 40.9 pg/mL, IQR, 38.1 to 43.6 pg/mL), as shown in Figure 1A. Similarly, serum FGF23 concentrations were progressively increased across the number of stenotic vessels (Figure 1B). Furthermore, the proportions of patients who had no stenosis were highest in the lowest quartile and lowest in the highest quartile of serum FGF23 values (45.8% and 9.2%). By contrast, the proportions of patients who had severe stenosis or 3-VD were lowest in the lowest quartile and highest in the highest quartile of serum FGF23 values (4.2% and 55.7% or 9.3% and 59.5%, P<0.001) (Figure 2).


Circulating fibroblast growth factor 23 is associated with angiographic severity and extent of coronary artery disease.

Xiao Y, Peng C, Huang W, Zhang J, Xia M, Zhang Y, Ling W - PLoS ONE (2013)

Box plots showing circulating FGF23 concentrations by angiographic extent of coronary artery disease.A. Severity of coronary artery stenosis. B. Number of stenosis vessels. Horizontal lines show median, 25th to 75th percentiles (boxes), and 10th to 90th percentiles (whiskers). FGF23 = Fibroblast growth factor 23, VD = vessel disease.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3755980&req=5

pone-0072545-g001: Box plots showing circulating FGF23 concentrations by angiographic extent of coronary artery disease.A. Severity of coronary artery stenosis. B. Number of stenosis vessels. Horizontal lines show median, 25th to 75th percentiles (boxes), and 10th to 90th percentiles (whiskers). FGF23 = Fibroblast growth factor 23, VD = vessel disease.
Mentions: To explore the relationship between serum FGF23 concentration and the severity and extent of CAD, we found a stepwise increase of serum FGF23 concentrations in patients with mild (median, 42.3 pg/mL; IQR, 38.9 to 46.9 pg/mL), moderate (median, 44.5 pg/mL; IQR, 41.1 to 53.7 pg/mL), severe stenosis (median, 50.6 pg/mL, IQR, 46.4 to 74.1 pg/mL) compared with those without stenosis (median, 40.9 pg/mL, IQR, 38.1 to 43.6 pg/mL), as shown in Figure 1A. Similarly, serum FGF23 concentrations were progressively increased across the number of stenotic vessels (Figure 1B). Furthermore, the proportions of patients who had no stenosis were highest in the lowest quartile and lowest in the highest quartile of serum FGF23 values (45.8% and 9.2%). By contrast, the proportions of patients who had severe stenosis or 3-VD were lowest in the lowest quartile and highest in the highest quartile of serum FGF23 values (4.2% and 55.7% or 9.3% and 59.5%, P<0.001) (Figure 2).

Bottom Line: Fibroblast growth factor 23 (FGF23) is a circulating regulator of phosphate and vitamin D metabolism and is associated with coronary artery calcification, and has been implicated in the pathogenesis of cardiovascular disease.Furthermore, subgroup analyses found FGF23 was significantly associated with plaque and dense calcium volumes.Multiple logistic regression analyses showed that serum FGF23 levels were significantly independent predictors of TVR and TLR.

View Article: PubMed Central - PubMed

Affiliation: Department of Nutrition and Food Hygiene, Shenzhen Centre for Disease Control and Prevention, Shenzhen, Guangdong, China ; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, Guangdong, China ; Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China.

ABSTRACT

Objective: Fibroblast growth factor 23 (FGF23) is a circulating regulator of phosphate and vitamin D metabolism and is associated with coronary artery calcification, and has been implicated in the pathogenesis of cardiovascular disease. The aim of this study was to determine whether circulating FGF23 concentration is independently associated with the severity and extent of coronary artery disease in patients undergoing coronary angiography.

Method: A cross-sectional design was used to examine the relationship between serum FGF23 and the severity and extent of coronary artery stenosis in 2076 patients undergoing coronary angiography (1263 male and 813 female, mean aged 62.5 years). Subgroup analyses were performed to assess the associations between FGF23 and coronary arterial plaque characteristics evaluated by intravascular ultrasound and 12-month incidence of target vessel revascularization (TVR) and target lesion revascularization (TLR).

Findings: We found a stepwise increase of serum FGF23 concentrations in patients with mild, moderate, severe stenosis or with increased number of stenotic vessels compared with those without stenosis (P<0.001). Serum FGF23 concentration was positively correlated with stenosis scores as the global index of the severity and extent of coronary artery stenosis in both male and female (r = 0.315 and r = 0.291, P<0.001). In multiple regression analyses, serum FGF23 concentration was a significant determinant of the stenosis scores independent of other traditional risk factors (standardized β = 0.326, P<0.001). Furthermore, subgroup analyses found FGF23 was significantly associated with plaque and dense calcium volumes. Multiple logistic regression analyses showed that serum FGF23 levels were significantly independent predictors of TVR and TLR.

Conclusions: We report an independent association between circulating FGF23 concentration and the severity and extent of coronary artery stenosis in the coronary angiographic patients. Future studies are needed to elucidate the potential biological mechanisms and whether FGF23 is a modifiable cardiovascular risk factor.

Show MeSH
Related in: MedlinePlus