Oliveira-Sousa Joana, Fragão-Marques Mariana, Duarte-Gamas Luís, Ribeiro Hugo, Rocha-Neves João
RISE-Health, Department of Biomedicine, Unit of Anatomy, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal.
Department of Angiology and Vascular Surgery, Local Health Unit Tâmega e Sousa, 4560-136 Penafiel, Portugal.
Med Sci (Basel). 2025 Mar 10;13(1):27. doi: 10.3390/medsci13010027.
BACKGROUND/OBJECTIVES: Carotid artery disease is a condition affecting 3% of the general population which significantly contributes to the development of cerebrovascular events. Fibroblast Growth Factor-23 (FGF-23) is a hormone that has been linked to atherosclerosis and increased cardiovascular risk, including stroke and myocardial infarction. This review explores the association of FGF-23 with carotid artery disease progression in an endarterectomy clinical context.
Based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), a search was performed relying on MEDLINE, Scopus and Web of Science, identifying publications focused on the correlation between serum FGF-23 and carotid artery disease. Assessment of study quality was made using National Heart, Lung and Blood Institute Study Quality Assessment Tool (NHLBI).
Three observational studies, comprising 1039 participants, were included. There was considerable heterogeneity among the populations from the different studies. Elevated FGF-23 levels were consistently associated with unstable plaque features, including intraplaque neovascularization, as identified through Superb Microvascular Imaging (SMI). Plasma levels of inflammatory mediators, such as Interleukin-6 (Il-6), Monocyte Chemoattractant Protein-1 (MCP-1), and Osteoprotegerin (OPG), positively correlated with carotid artery disease, but their link to unstable plaques is conflicting. None of the studies investigated clinical complications following carotid endarterectomy.
FGF-23 is a potential biomarker for plaque vulnerability in carotid disease. Despite promising findings, limitations such as small sample sizes and lack of longitudinal data suggest the need for larger and more diverse studies to improve risk stratification and inform personalized treatment strategies for carotid atherosclerosis.
背景/目的：颈动脉疾病影响着3%的普通人群，是导致脑血管事件发生的重要因素。成纤维细胞生长因子-23（FGF-23）是一种与动脉粥样硬化及心血管疾病风险增加（包括中风和心肌梗死）相关的激素。本综述探讨了在颈动脉内膜切除术临床背景下FGF-23与颈动脉疾病进展的关联。
依据系统评价和Meta分析的首选报告项目（PRISMA），通过检索MEDLINE、Scopus和科学网，筛选出关注血清FGF-23与颈动脉疾病相关性的文献。使用美国国立心肺血液研究所研究质量评估工具（NHLBI）对研究质量进行评估。
纳入了三项观察性研究，共1039名参与者。不同研究的人群存在较大异质性。通过超微血管成像（SMI）发现，FGF-23水平升高与不稳定斑块特征（包括斑块内新生血管形成）始终相关。炎症介质如白细胞介素-6（Il-6）、单核细胞趋化蛋白-1（MCP-1）和骨保护素（OPG）的血浆水平与颈动脉疾病呈正相关，但其与不稳定斑块的关联存在矛盾。所有研究均未调查颈动脉内膜切除术后的临床并发症。
FGF-23是颈动脉疾病中斑块易损性的潜在生物标志物。尽管有一些有前景的发现，但样本量小和缺乏纵向数据等局限性表明，需要开展更大规模、更多样化的研究，以改善风险分层，并为颈动脉粥样硬化的个性化治疗策略提供依据。
