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Fibroblast growth factor 23 and cognitive impairment: The health, aging, and body composition study

BACKGROUND: Concentrations of fibroblast growth factor 23 (FGF-23), a hormone that regulates phosphorus and vitamin D metabolism, increase as kidney function declines. Excess fibroblast growth factor 23 may impact brain function through promotion of vascular disease or through direct effects on neur...

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Autores principales: Drew, David A., Katz, Ronit, Kritchevsky, Stephen, Ix, Joachim H., Shlipak, Michael, Newman, Anne B., Hoofnagle, Andy, Fried, Linda, Gutiérrez, Orlando M., Sarnak, Mark
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7732072/
https://www.ncbi.nlm.nih.gov/pubmed/33306729
http://dx.doi.org/10.1371/journal.pone.0243872
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author Drew, David A.
Katz, Ronit
Kritchevsky, Stephen
Ix, Joachim H.
Shlipak, Michael
Newman, Anne B.
Hoofnagle, Andy
Fried, Linda
Gutiérrez, Orlando M.
Sarnak, Mark
author_facet Drew, David A.
Katz, Ronit
Kritchevsky, Stephen
Ix, Joachim H.
Shlipak, Michael
Newman, Anne B.
Hoofnagle, Andy
Fried, Linda
Gutiérrez, Orlando M.
Sarnak, Mark
author_sort Drew, David A.
collection PubMed
description BACKGROUND: Concentrations of fibroblast growth factor 23 (FGF-23), a hormone that regulates phosphorus and vitamin D metabolism, increase as kidney function declines. Excess fibroblast growth factor 23 may impact brain function through promotion of vascular disease or through direct effects on neuronal tissue. METHODS: In the Healthy Aging and Body Composition Study, a longitudinal observational cohort of well-functioning older adults, intact serum FGF-23 was assayed in 2,738 individuals. Cognitive function was assessed at baseline and longitudinally at years 3, 5, and 8 by administration of the Modified Mini Mental State Examination (3MSE), a test of global cognitive function, and the Digit Symbol Substitution Test (DSST), a test primarily of executive function. The associations between FGF-23 and baseline cognitive function and incident cognitive impairment were evaluated using logistic and Poisson regression respectively, and were adjusted for demographics, baseline estimated glomerular filtration rate (eGFR), urine albumin/creatinine ratio, comorbidity, and other measures of mineral metabolism including soluble klotho. RESULTS: The mean (SD) age was 74(3) years, with 51% female, and 39% black. The median (25th, 75th) FGF-23 concentration was 47 pg/mL (37, 60). Three hundred ninety-two individuals had prevalent cognitive impairment by the 3MSE and 461 by the DSST. There was no observed association between FGF-23 and baseline cognitive function for either cognitive test. There were 277 persons with incident cognitive impairment by 3MSE, and 333 persons with incident cognitive impairment by DSST. In fully adjusted models, each two-fold higher concentration of baseline FGF-23 was not associated with incident cognitive impairment by the 3MSE (IRR = 1.02[0.88, 1.19] fully adjusted model) or by the DSST (IRR = 0.98 [0.84, 1.15]. We saw no difference when analyses were stratified by eGFR greater than or less than 60 ml/min/1.73m(2). CONCLUSION: Intact FGF-23 was not associated with baseline cognitive function or incident cognitive impairment in this cohort well-functioning older adults.
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spelling pubmed-77320722020-12-17 Fibroblast growth factor 23 and cognitive impairment: The health, aging, and body composition study Drew, David A. Katz, Ronit Kritchevsky, Stephen Ix, Joachim H. Shlipak, Michael Newman, Anne B. Hoofnagle, Andy Fried, Linda Gutiérrez, Orlando M. Sarnak, Mark PLoS One Research Article BACKGROUND: Concentrations of fibroblast growth factor 23 (FGF-23), a hormone that regulates phosphorus and vitamin D metabolism, increase as kidney function declines. Excess fibroblast growth factor 23 may impact brain function through promotion of vascular disease or through direct effects on neuronal tissue. METHODS: In the Healthy Aging and Body Composition Study, a longitudinal observational cohort of well-functioning older adults, intact serum FGF-23 was assayed in 2,738 individuals. Cognitive function was assessed at baseline and longitudinally at years 3, 5, and 8 by administration of the Modified Mini Mental State Examination (3MSE), a test of global cognitive function, and the Digit Symbol Substitution Test (DSST), a test primarily of executive function. The associations between FGF-23 and baseline cognitive function and incident cognitive impairment were evaluated using logistic and Poisson regression respectively, and were adjusted for demographics, baseline estimated glomerular filtration rate (eGFR), urine albumin/creatinine ratio, comorbidity, and other measures of mineral metabolism including soluble klotho. RESULTS: The mean (SD) age was 74(3) years, with 51% female, and 39% black. The median (25th, 75th) FGF-23 concentration was 47 pg/mL (37, 60). Three hundred ninety-two individuals had prevalent cognitive impairment by the 3MSE and 461 by the DSST. There was no observed association between FGF-23 and baseline cognitive function for either cognitive test. There were 277 persons with incident cognitive impairment by 3MSE, and 333 persons with incident cognitive impairment by DSST. In fully adjusted models, each two-fold higher concentration of baseline FGF-23 was not associated with incident cognitive impairment by the 3MSE (IRR = 1.02[0.88, 1.19] fully adjusted model) or by the DSST (IRR = 0.98 [0.84, 1.15]. We saw no difference when analyses were stratified by eGFR greater than or less than 60 ml/min/1.73m(2). CONCLUSION: Intact FGF-23 was not associated with baseline cognitive function or incident cognitive impairment in this cohort well-functioning older adults. Public Library of Science 2020-12-11 /pmc/articles/PMC7732072/ /pubmed/33306729 http://dx.doi.org/10.1371/journal.pone.0243872 Text en © 2020 Drew et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Drew, David A.
Katz, Ronit
Kritchevsky, Stephen
Ix, Joachim H.
Shlipak, Michael
Newman, Anne B.
Hoofnagle, Andy
Fried, Linda
Gutiérrez, Orlando M.
Sarnak, Mark
Fibroblast growth factor 23 and cognitive impairment: The health, aging, and body composition study
title Fibroblast growth factor 23 and cognitive impairment: The health, aging, and body composition study
title_full Fibroblast growth factor 23 and cognitive impairment: The health, aging, and body composition study
title_fullStr Fibroblast growth factor 23 and cognitive impairment: The health, aging, and body composition study
title_full_unstemmed Fibroblast growth factor 23 and cognitive impairment: The health, aging, and body composition study
title_short Fibroblast growth factor 23 and cognitive impairment: The health, aging, and body composition study
title_sort fibroblast growth factor 23 and cognitive impairment: the health, aging, and body composition study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7732072/
https://www.ncbi.nlm.nih.gov/pubmed/33306729
http://dx.doi.org/10.1371/journal.pone.0243872
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