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The Association between Fibroblast Growth Factor-23 and Vascular Calcification Is Mitigated by Inflammation Markers

BACKGROUND: Fibroblast growth factor-23 (FGF-23) has been linked to vascular calcification, ventricular hypertrophy and mortality in chronic kidney disease (CKD), although these links may not be direct and independent. Similar grave outcomes are associated with inflammation and oxidative stress in C...

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Autores principales: NasrAllah, Mohamed M., El-Shehaby, Amal R., Osman, Noha A., Fayad, Tarek, Nassef, Amr, Salem, Mona M., Sharaf El Din, Usama A.A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3843931/
https://www.ncbi.nlm.nih.gov/pubmed/24348506
http://dx.doi.org/10.1159/000356118
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author NasrAllah, Mohamed M.
El-Shehaby, Amal R.
Osman, Noha A.
Fayad, Tarek
Nassef, Amr
Salem, Mona M.
Sharaf El Din, Usama A.A.
author_facet NasrAllah, Mohamed M.
El-Shehaby, Amal R.
Osman, Noha A.
Fayad, Tarek
Nassef, Amr
Salem, Mona M.
Sharaf El Din, Usama A.A.
author_sort NasrAllah, Mohamed M.
collection PubMed
description BACKGROUND: Fibroblast growth factor-23 (FGF-23) has been linked to vascular calcification, ventricular hypertrophy and mortality in chronic kidney disease (CKD), although these links may not be direct and independent. Similar grave outcomes are associated with inflammation and oxidative stress in CKD. Recently, accumulating evidence has linked components of phosphate homeostasis to inflammation and oxidative stress. The interaction between the triad of inflammation, FGF-23 and cardiovascular outcomes is underinvestigated. METHODS: We studied 65 patients with stage 5 CKD on hemodialysis. Serum levels of FGF-23, high-sensitivity C-reactive protein (hsCRP), endogenous soluble receptor of advanced glycation end products (esRAGE), advanced oxidation protein products (AOPP), parathormone, lipids, calcium and phosphorous were measured. The aortic calcification index (ACI) was determined using non-contrast CT scans of the abdominal aorta. RESULTS: FGF-23 was elevated (mean: 4,681 pg/ml, SD: 3,906) and correlated with hsCRP, esRAGE, AOPP, dialysis vintage and phosphorus in univariate analysis. In multiple regression analysis, hsCRP, AOPP and phosphorus but not esRAGE were all significantly correlated to FGF-23 (R(2) = 0.7, p < 0.001). In univariate analysis, ACI correlated with hsCRP, esRAGE, FGF-23, dialysis vintage, systolic blood pressure (BP) and serum cholesterol. In multiple regression analysis not including inflammation markers, ACI was associated with FGF-23. However, inclusion of inflammation markers in another multiple regression analyses showed that ACI correlated with hsCRP, BP, dialysis vintage and esRAGE but not with FGF-23 (R(2) = 0.65, p < 0.001). CONCLUSION: FGF-23 is strongly correlated to various markers of inflammation and oxidative stress in hemodialysis patients. The association between FGF-23 and vascular calcification was mitigated when corrected for inflammation markers.
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spelling pubmed-38439312013-12-12 The Association between Fibroblast Growth Factor-23 and Vascular Calcification Is Mitigated by Inflammation Markers NasrAllah, Mohamed M. El-Shehaby, Amal R. Osman, Noha A. Fayad, Tarek Nassef, Amr Salem, Mona M. Sharaf El Din, Usama A.A. Nephron Extra Original Paper BACKGROUND: Fibroblast growth factor-23 (FGF-23) has been linked to vascular calcification, ventricular hypertrophy and mortality in chronic kidney disease (CKD), although these links may not be direct and independent. Similar grave outcomes are associated with inflammation and oxidative stress in CKD. Recently, accumulating evidence has linked components of phosphate homeostasis to inflammation and oxidative stress. The interaction between the triad of inflammation, FGF-23 and cardiovascular outcomes is underinvestigated. METHODS: We studied 65 patients with stage 5 CKD on hemodialysis. Serum levels of FGF-23, high-sensitivity C-reactive protein (hsCRP), endogenous soluble receptor of advanced glycation end products (esRAGE), advanced oxidation protein products (AOPP), parathormone, lipids, calcium and phosphorous were measured. The aortic calcification index (ACI) was determined using non-contrast CT scans of the abdominal aorta. RESULTS: FGF-23 was elevated (mean: 4,681 pg/ml, SD: 3,906) and correlated with hsCRP, esRAGE, AOPP, dialysis vintage and phosphorus in univariate analysis. In multiple regression analysis, hsCRP, AOPP and phosphorus but not esRAGE were all significantly correlated to FGF-23 (R(2) = 0.7, p < 0.001). In univariate analysis, ACI correlated with hsCRP, esRAGE, FGF-23, dialysis vintage, systolic blood pressure (BP) and serum cholesterol. In multiple regression analysis not including inflammation markers, ACI was associated with FGF-23. However, inclusion of inflammation markers in another multiple regression analyses showed that ACI correlated with hsCRP, BP, dialysis vintage and esRAGE but not with FGF-23 (R(2) = 0.65, p < 0.001). CONCLUSION: FGF-23 is strongly correlated to various markers of inflammation and oxidative stress in hemodialysis patients. The association between FGF-23 and vascular calcification was mitigated when corrected for inflammation markers. S. Karger AG 2013-11-06 /pmc/articles/PMC3843931/ /pubmed/24348506 http://dx.doi.org/10.1159/000356118 Text en Copyright © 2013 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC) (www.karger.com/OA-license), applicable to the online version of the article only. Users may download, print and share this work on the Internet for noncommercial purposes only, provided the original work is properly cited, and a link to the original work on http://www.karger.com and the terms of this license are included in any shared versions.
spellingShingle Original Paper
NasrAllah, Mohamed M.
El-Shehaby, Amal R.
Osman, Noha A.
Fayad, Tarek
Nassef, Amr
Salem, Mona M.
Sharaf El Din, Usama A.A.
The Association between Fibroblast Growth Factor-23 and Vascular Calcification Is Mitigated by Inflammation Markers
title The Association between Fibroblast Growth Factor-23 and Vascular Calcification Is Mitigated by Inflammation Markers
title_full The Association between Fibroblast Growth Factor-23 and Vascular Calcification Is Mitigated by Inflammation Markers
title_fullStr The Association between Fibroblast Growth Factor-23 and Vascular Calcification Is Mitigated by Inflammation Markers
title_full_unstemmed The Association between Fibroblast Growth Factor-23 and Vascular Calcification Is Mitigated by Inflammation Markers
title_short The Association between Fibroblast Growth Factor-23 and Vascular Calcification Is Mitigated by Inflammation Markers
title_sort association between fibroblast growth factor-23 and vascular calcification is mitigated by inflammation markers
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3843931/
https://www.ncbi.nlm.nih.gov/pubmed/24348506
http://dx.doi.org/10.1159/000356118
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