Fibroblast Growth Factor 23 and Incident Cardiovascular Disease and Mortality in Middle‐Aged Adults
Background Higher circulating fibroblast growth factor 23 (FGF23) associates with greater risk of cardiovascular disease (CVD) and mortality in older adults. The association of FGF23 with cardiovascular outcomes in younger populations has been incompletely explored. Methods and Results We measured C...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-08-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.120.020196 |
| _version_ | 1797810222241153024 |
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| author | Shejuti Paul Mandy Wong Ehimare Akhabue Rupal C. Mehta Holly Kramer Tamara Isakova Mercedes R. Carnethon Myles Wolf Orlando M. Gutiérrez |
| author_facet | Shejuti Paul Mandy Wong Ehimare Akhabue Rupal C. Mehta Holly Kramer Tamara Isakova Mercedes R. Carnethon Myles Wolf Orlando M. Gutiérrez |
| author_sort | Shejuti Paul |
| collection | DOAJ |
| description | Background Higher circulating fibroblast growth factor 23 (FGF23) associates with greater risk of cardiovascular disease (CVD) and mortality in older adults. The association of FGF23 with cardiovascular outcomes in younger populations has been incompletely explored. Methods and Results We measured C‐terminal FGF23 (cFGF23) and intact FGF23 (iFGF23) in 3151 middle‐aged adults (mean age, 45±4) who participated in the year 20 examination of the CARDIA (Coronary Artery Risk Development in Young Adults) study. We used separate Cox proportional hazards models to examine the associations of cFGF23 and iFGF23 with incident CVD and mortality, adjusting models sequentially for sociodemographic, clinical, and laboratory factors. A total of 157 incident CVD events and 135 deaths occurred over a median 7.6 years of follow‐up (interquartile range, 4.1–9.9). In fully adjusted models, there were no statistically significant associations of FGF23 with incident CVD events (hazard ratio per doubling of cFGF23: 1.14, 95%CI 0.97,1.34; iFGF23: 0.76, 95%CI 0.57,1.02) or all‐cause mortality (hazard ratio per doubling of cFGF23, 1.17; 95% CI, 1.00–1.38; iFGF23, 0.86; 95% CI, 0.64–1.17). In analyses stratified by CVD subtypes, higher cFGF23 was associated with greater risk of heart failure hospitalization (hazard ratio per doubling of cFGF23, 1.52; 95% CI, 1.18–1.96) but not coronary heart disease or stroke, whereas iFGF23 was not associated with CVD subtypes in any model. Conclusions In middle‐aged adults with few comorbidities, higher cFGF23 and iFGF23 were not independently associated with greater risk of CVD events or death. Higher cFGF23 was independently associated with greater risk of heart failure hospitalization. |
| first_indexed | 2024-03-13T07:05:58Z |
| format | Article |
| id | doaj.art-df2bc466ef5441efad23b9a4a12bdcb4 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-03-13T07:05:58Z |
| publishDate | 2021-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-df2bc466ef5441efad23b9a4a12bdcb42023-06-06T12:10:51ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802021-08-01101610.1161/JAHA.120.020196Fibroblast Growth Factor 23 and Incident Cardiovascular Disease and Mortality in Middle‐Aged AdultsShejuti Paul0Mandy Wong1Ehimare Akhabue2Rupal C. Mehta3Holly Kramer4Tamara Isakova5Mercedes R. Carnethon6Myles Wolf7Orlando M. Gutiérrez8Department of Medicine University of Alabama at Birmingham Birmingham ALDepartment of Preventive Medicine Northwestern University Chicago ILDepartment of Medicine Rutgers Robert Wood Johnson Medical School New Brunswick NJDepartment of Medicine and Center for Translational Metabolism and Health Northwestern University Chicago ILDepartment of Medicine Loyola University Maywood ILDepartment of Medicine and Center for Translational Metabolism and Health Northwestern University Chicago ILDepartment of Preventive Medicine Northwestern University Chicago ILDivision of Nephrology Department of Medicine, and Duke Clinical Research Institute Duke University Durham NCDepartment of Medicine University of Alabama at Birmingham Birmingham ALBackground Higher circulating fibroblast growth factor 23 (FGF23) associates with greater risk of cardiovascular disease (CVD) and mortality in older adults. The association of FGF23 with cardiovascular outcomes in younger populations has been incompletely explored. Methods and Results We measured C‐terminal FGF23 (cFGF23) and intact FGF23 (iFGF23) in 3151 middle‐aged adults (mean age, 45±4) who participated in the year 20 examination of the CARDIA (Coronary Artery Risk Development in Young Adults) study. We used separate Cox proportional hazards models to examine the associations of cFGF23 and iFGF23 with incident CVD and mortality, adjusting models sequentially for sociodemographic, clinical, and laboratory factors. A total of 157 incident CVD events and 135 deaths occurred over a median 7.6 years of follow‐up (interquartile range, 4.1–9.9). In fully adjusted models, there were no statistically significant associations of FGF23 with incident CVD events (hazard ratio per doubling of cFGF23: 1.14, 95%CI 0.97,1.34; iFGF23: 0.76, 95%CI 0.57,1.02) or all‐cause mortality (hazard ratio per doubling of cFGF23, 1.17; 95% CI, 1.00–1.38; iFGF23, 0.86; 95% CI, 0.64–1.17). In analyses stratified by CVD subtypes, higher cFGF23 was associated with greater risk of heart failure hospitalization (hazard ratio per doubling of cFGF23, 1.52; 95% CI, 1.18–1.96) but not coronary heart disease or stroke, whereas iFGF23 was not associated with CVD subtypes in any model. Conclusions In middle‐aged adults with few comorbidities, higher cFGF23 and iFGF23 were not independently associated with greater risk of CVD events or death. Higher cFGF23 was independently associated with greater risk of heart failure hospitalization.https://www.ahajournals.org/doi/10.1161/JAHA.120.020196cardiovascular diseasedeathfibroblast growth factor 23heart failurephosphorus |
| spellingShingle | Shejuti Paul Mandy Wong Ehimare Akhabue Rupal C. Mehta Holly Kramer Tamara Isakova Mercedes R. Carnethon Myles Wolf Orlando M. Gutiérrez Fibroblast Growth Factor 23 and Incident Cardiovascular Disease and Mortality in Middle‐Aged Adults Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cardiovascular disease death fibroblast growth factor 23 heart failure phosphorus |
| title | Fibroblast Growth Factor 23 and Incident Cardiovascular Disease and Mortality in Middle‐Aged Adults |
| title_full | Fibroblast Growth Factor 23 and Incident Cardiovascular Disease and Mortality in Middle‐Aged Adults |
| title_fullStr | Fibroblast Growth Factor 23 and Incident Cardiovascular Disease and Mortality in Middle‐Aged Adults |
| title_full_unstemmed | Fibroblast Growth Factor 23 and Incident Cardiovascular Disease and Mortality in Middle‐Aged Adults |
| title_short | Fibroblast Growth Factor 23 and Incident Cardiovascular Disease and Mortality in Middle‐Aged Adults |
| title_sort | fibroblast growth factor 23 and incident cardiovascular disease and mortality in middle aged adults |
| topic | cardiovascular disease death fibroblast growth factor 23 heart failure phosphorus |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.120.020196 |
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