Association of serum FGF-23, klotho, fetuin-A, osteopontin, osteoprotegerin and hs-CRP levels with coronary artery disease.

Environmental, genetic, oxidative and biochemical factors play an important role in the atherosclerotic process. We investigated the association of serum fibroblast growth factor (FGF-23), klotho, fetuin-A, osteoprotegerin (OPG), osteopontin (OPN) and high-sensitive-CRP (Hs-CRP) markers with coronary artery disease and whether one was superior to others or not. A study group of 52 patients with coronary artery disease (CAD) and a control group of 30 patients with angiographically normal epicardial coronary arteries were included in the study. Serum FGF-23, klotho, fetuin-A, OPN, OPG and Hs-CRP marker levels were studied. Patients with CAD were classified in two groups as low (SYNTAX ≤22,  = 29) and moderate-high (SYNTAX ≥ 23,  = 23) according to anatomic SYNTAX score. FGF-23 ( = .033), klotho ( < .001), fetuin-A ( = .005) and OPG ( = .001) serum marker levels were significantly lower in CAD patients than the control group. Serum levels of FGF-23 ( = .012), klotho ( = .001), fetuin-A ( = .015) and OPG ( = 0.002) were significantly different between SYNTAX tertiles and control group. Klotho ( = .025, odd ratio (OR) = 0.542, 95% confidence interval (CI): 0.317-0.926) and HT ( = .004, OR = 34.598, 95%CI:1.054-1135.657) were the independent predictors of CAD presence. Serum klotho levels of 91.48 pmol/L predicts the presence of CAD with 60% sensitivity and 96.55% specificity ( < .001, area under curve = 0.864, 95% CI = 0.768, 0.931). We found that serum klotho level is an independent predictor of presence, extent and severity of CAD.