Akin Fatih, Celik Omer, Ayca Burak, Altun Ibrahim, Diker Vesile Ornek, Bıyık Ismail, Siriopol Dimitrie, Covic Adrian, Kanbay Mehmet
From the *Department of Cardiology, Muğla Sıtkı Kocman University School of Medicine, Muğla; †Department of Cardiology, Mehmet Akif Ersoy Chest and Cardiovascular Surgery Education and Research Hospital; and ‡Department of Cardiology, Bağcılar Education and Research Hospital, Istanbul; and §Department of Biochemistry, Mehmet Akif Ersoy Chest and Cardiovascular Surgery Education and Research Hospital, Istanbul, Turkey; ║Nephrology Clinic, Dialysis and Renal Transplant Center, G. I. Popa University Hospital of Medicine and Pharmacy, Iasi, Romania; and ¶Division of Nephrology, Department of Medicine, Koc University School of Medicine, Istanbul, Turkey.
J Investig Med. 2015 Apr;63(4):613-9. doi: 10.1097/JIM.0000000000000153.
The total burden of subclinical coronary artery disease (CAD) is significant among young adults. Serum fibroblast growth factor 23 (FGF-23) and fetuin-A are established predictors of morbidity and mortality because of cardiovascular disease. The objective of the study was to evaluate the relationship between subclinical CAD and serum FGF-23 and fetuin-A concentrations among a population of young adults.
A total of 241 subjects younger than 45 years who had undergone coronary computed tomographic angiography (CCTA) were included in the study. In 117 patients, the CCTA detected subclinical CAD; the rest of the patients had no CAD detected on CCTA.
Serum FGF-23 and fetuin-A levels were significantly increased in the CAD patients as compared with the non-CAD patients (26.7 [interquartile range, 22.4-31.9] vs 15.7 [interquartile range, 13.2-18.1] pg/mL and 904.7 [interquartile range, 695.5-1021.6] vs 469.6 [331.4-660.5] mg/L, respectively; P < 0.001 for both). Furthermore, a positive correlation was identified between FGF-23 and fetuin-A levels and the total number of plaques (r = 0.21 and r = 0.28, respectively; P < 0.001 for both). In multivariate logistic regression analysis, age, smoking status, uric acid, FGF-23, and fetuin-A levels were found to be independently associated with the presence of CAD.
The presence of subclinical CAD is independently associated with FGF-23 and fetuin-A and could be used as novel risk markers of cardiovascular disease in the asymptomatic young adult population.
亚临床冠状动脉疾病（CAD）在年轻成年人中的总体负担较重。血清成纤维细胞生长因子23（FGF - 23）和胎球蛋白A是心血管疾病发病和死亡的既定预测指标。本研究的目的是评估年轻成年人群中亚临床CAD与血清FGF - 23和胎球蛋白A浓度之间的关系。
本研究纳入了241名年龄小于45岁且接受过冠状动脉计算机断层血管造影（CCTA）的受试者。其中117例患者的CCTA检测到亚临床CAD；其余患者的CCTA未检测到CAD。
与无CAD患者相比，CAD患者的血清FGF - 23和胎球蛋白A水平显著升高（分别为26.7[四分位数间距，22.4 - 31.9] vs 15.7[四分位数间距，13.2 - 18.1] pg/mL和904.7[四分位数间距，695.5 - 1021.6] vs 469.6[331.4 - 660.5] mg/L；两者P均<0.001）。此外，FGF - 23和胎球蛋白A水平与斑块总数之间存在正相关（r分别为0.21和0.28；两者P均<0.001）。在多因素逻辑回归分析中，年龄、吸烟状况、尿酸、FGF - 23和胎球蛋白A水平被发现与CAD的存在独立相关。
亚临床CAD的存在与FGF - 23和胎球蛋白A独立相关，可作为无症状年轻成年人群心血管疾病的新型风险标志物。
