Department of Ophthalmology, Johns Hopkins University School of Medicine, M015, Smith Building, 400 North Broadway, Baltimore, Maryland 21287, USA.
Eur J Endocrinol. 2011 Nov;165(5):797-803. doi: 10.1530/EJE-11-0577. Epub 2011 Aug 26.
Although fibroblast growth factor 23 (FGF23) has been implicated in the pathogenesis of cardiovascular disease, the relationship between FGF23 and cardiovascular disease has not been well characterized in the general population. The aim of this study was to determine whether serum FGF23 is independently associated with cardiovascular disease in older community-dwelling women.
A cross-sectional design was used to examine the relationship between serum FGF23 and cardiovascular disease. The subjects consisted of a population-based sample of 659 women, aged 70-79 years, who participated in the Women's Health and Aging Studies in Baltimore, Maryland. Prevalent cardiovascular disease (coronary heart disease, stroke, congestive heart failure, and peripheral artery disease) was assessed through diagnostic algorithms and physician adjudication.
Of the 659 women, 185 (28.1%) had cardiovascular disease. Median (25th, 75th percentile) intact serum FGF23 was 34.6 (25.2, 46.2) pg/ml. The prevalence of cardiovascular disease in the lowest, middle, and highest tertile of serum FGF23 was 22.6, 24.9, and 36.7% respectively (P=0.002). Serum log FGF23 was associated with cardiovascular disease (odds ratio per 1 s.d. increase=1.23, 95% confidence interval 1.17, 1.30; P<0.0001) in a multivariable logistic regression model, adjusting for age, race, smoking, education, body mass index, cognition, diabetes, hypertension, physical activity, total cholesterol, high-density lipoprotein cholesterol, and renal function.
Elevated serum FGF23 concentrations are independently associated with prevalent cardiovascular disease in older community-dwelling women. Further studies are needed to elucidate the potential biological mechanisms by which FGF23 may be involved in the pathogenesis of cardiovascular disease.
虽然成纤维细胞生长因子 23（FGF23）与心血管疾病的发病机制有关，但在普通人群中，FGF23 与心血管疾病的关系尚未得到很好的描述。本研究旨在确定血清 FGF23 是否与老年社区居住女性的心血管疾病独立相关。
采用横断面设计研究血清 FGF23 与心血管疾病的关系。研究对象为马里兰州巴尔的摩市妇女健康与衰老研究中的一个基于人群的 659 名年龄在 70-79 岁的女性。通过诊断算法和医生判断评估心血管疾病的患病率（冠心病、中风、充血性心力衰竭和外周动脉疾病）。
在 659 名女性中，185 名（28.1%）患有心血管疾病。完整血清 FGF23 的中位数（25 分位数，75 分位数）为 34.6（25.2，46.2）pg/ml。血清 FGF23 最低、中、最高三分位组的心血管疾病患病率分别为 22.6%、24.9%和 36.7%（P=0.002）。在调整年龄、种族、吸烟、教育程度、体重指数、认知、糖尿病、高血压、体力活动、总胆固醇、高密度脂蛋白胆固醇和肾功能后，血清 log FGF23 与心血管疾病相关（每增加 1 个标准差的比值比=1.23，95%置信区间 1.17，1.30；P<0.0001）。
血清 FGF23 浓度升高与老年社区居住女性的心血管疾病患病率独立相关。需要进一步研究阐明 FGF23 如何参与心血管疾病发病机制的潜在生物学机制。
