TY - JOUR
T1 - Plasma FGF23 and Calcified Atherosclerotic Plaque in African Americans with Type 2 Diabetes Mellitus
AU - Freedman, Barry I.
AU - Divers, Jasmin
AU - Russell, Gregory B.
AU - Palmer, Nicholette D.
AU - Bowden, Donald W.
AU - Carr, J. Jeffrey
AU - Wagenknecht, Lynne E.
AU - Hightower, R. Caresse
AU - Xu, Jianzhao
AU - Smith, Susan Carrie
AU - Langefeld, Carl D.
AU - Hruska, Keith A.
AU - Register, Thomas C.
N1 - Funding Information:
We thank study participants and research coordinators Benita Bowman and Benjamin Bagwell. The authors report no conflicts of interest in the performance of this work. The results presented in this paper have not been published previously in whole or part, except in the abstract format. No author reports a conflict of interest related to this work. This research was supported in part by the General Clinical Research Center of the WFSM grant M01 RR07122; and NIH grants RO1 DK071891 (B.I.F.), AR48797 (J.J.C.), HL67348 (D.W.B.), DK089137 and DK070790 (K.A.H.).
Publisher Copyright:
© 2016 S. Karger AG.
PY - 2015/12/1
Y1 - 2015/12/1
N2 - Background: Fibroblast growth factor 23 (FGF23) is a phosphaturic hormone implicated in disorders of serum phosphorus concentration and vitamin D. The role of FGF23 in vascular calcification remains controversial. Methods: Relationships between FGF23 and coronary artery calcified atherosclerotic plaque (CAC), aortoiliac calcified plaque (CP), carotid artery CP, volumetric bone mineral density (vBMD), albuminuria, and estimated glomerular filtration rate (eGFR) were determined in 545 African Americans with type 2 diabetes (T2D) and preserved kidney function in African American-Diabetes Heart Study participants. Generalized linear models were fitted to test associations between FGF23 and cardiovascular, bone, and renal phenotypes, and change in measurements over time, adjusting for age, gender, African ancestry proportion, body mass index, diabetes duration, hemoglobin A1c, blood pressure, renin-angiotensin-system inhibitors, statins, calcium supplements, serum calcium, and serum phosphate. Results: The sample was 56.7% female with a mean (SD) age of 55.6 (9.6) years, diabetes duration of 10.3 (8.2) years, eGFR 90.9 (22.1) ml/min/1.73 m2, urine albumin:creatinine ratio (UACR) 151 (588) (median 13) mg/g, plasma FGF23 161 (157) RU/ml, and CAC 637 (1,179) mg. In fully adjusted models, FGF23 was negatively associated with eGFR (p < 0.0001) and positively associated with UACR (p < 0.0001) and CAC (p = 0.0006), but not with carotid CP or aortic CP. Baseline FGF23 concentration did not associate with changes in vBMD or CAC after a mean of 5.1 years follow-up. Conclusions: Plasma FGF23 concentrations were independently associated with subclinical coronary artery disease, albuminuria, and kidney function in the understudied African American population with T2D. Findings support relationships between FGF23 and vascular calcification, but not between FGF23 and bone mineral density, in African Americans lacking advanced nephropathy.
AB - Background: Fibroblast growth factor 23 (FGF23) is a phosphaturic hormone implicated in disorders of serum phosphorus concentration and vitamin D. The role of FGF23 in vascular calcification remains controversial. Methods: Relationships between FGF23 and coronary artery calcified atherosclerotic plaque (CAC), aortoiliac calcified plaque (CP), carotid artery CP, volumetric bone mineral density (vBMD), albuminuria, and estimated glomerular filtration rate (eGFR) were determined in 545 African Americans with type 2 diabetes (T2D) and preserved kidney function in African American-Diabetes Heart Study participants. Generalized linear models were fitted to test associations between FGF23 and cardiovascular, bone, and renal phenotypes, and change in measurements over time, adjusting for age, gender, African ancestry proportion, body mass index, diabetes duration, hemoglobin A1c, blood pressure, renin-angiotensin-system inhibitors, statins, calcium supplements, serum calcium, and serum phosphate. Results: The sample was 56.7% female with a mean (SD) age of 55.6 (9.6) years, diabetes duration of 10.3 (8.2) years, eGFR 90.9 (22.1) ml/min/1.73 m2, urine albumin:creatinine ratio (UACR) 151 (588) (median 13) mg/g, plasma FGF23 161 (157) RU/ml, and CAC 637 (1,179) mg. In fully adjusted models, FGF23 was negatively associated with eGFR (p < 0.0001) and positively associated with UACR (p < 0.0001) and CAC (p = 0.0006), but not with carotid CP or aortic CP. Baseline FGF23 concentration did not associate with changes in vBMD or CAC after a mean of 5.1 years follow-up. Conclusions: Plasma FGF23 concentrations were independently associated with subclinical coronary artery disease, albuminuria, and kidney function in the understudied African American population with T2D. Findings support relationships between FGF23 and vascular calcification, but not between FGF23 and bone mineral density, in African Americans lacking advanced nephropathy.
KW - African American
KW - Albuminuria
KW - Calcified atherosclerotic plaque
KW - FGF23
KW - Kidney disease
KW - Type 2 diabetes mellitus
UR - http://www.scopus.com/inward/record.url?scp=84953748865&partnerID=8YFLogxK
U2 - 10.1159/000443241
DO - 10.1159/000443241
M3 - Article
C2 - 26693712
AN - SCOPUS:84953748865
SN - 0250-8095
VL - 42
SP - 391
EP - 401
JO - American Journal of Nephrology
JF - American Journal of Nephrology
IS - 6
ER -