Associations of serum fibroblast growth factor 23 with dyslipidemia and carotid atherosclerosis in chronic kidney disease stages 3-5D

作者：Yan, Jiayi; Zhang, Minfang^*; Ni, Zhaohui; Jin, Shi; Zhu, Mingli; Pang, Huihua

来源：International Journal of Clinical and Experimental Medicine, 2017, 10(9): 13588-13597.

• Fibroblast growth factor 23
• chronic kidney disease
• dyslipidemia
• carotid atherosclerosis

Background and aim: Fibroblast growth factor 23 (FGF23) has been associated with mineral disorders and poor outcomes in patients with chronic kidney disease (CKD). Since FGF23 shares structural similarities with FGF19 subfamily members, which play a role in lipid metabolism, we examined the relationship of FGF23 with lipid metabolism and carotid atherosclerosis in CKD patients. Material and methods: A sample of 180 patients with CKD stages 3-5D, and 50 controls were recruited. Baseline serum intact FGF23 levels were measured and the associations of FGF23 with total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and body mass index (BMI) were explored. Carotid atherosclerosis was assessed using ultrasound. Results: In CKD patients, a per SD increase in logFGF23 was associated with lower TC (beta=-0.37; P=0.041), LDL-C (beta=-0.33; P=0.040), HDL-C (beta=-0.14; P=0.027), BMI (beta=-1.15; P=0.030), increased carotid intima media thickness (CIMT) (beta=0.03; P=0.037), higher risk of carotid plaque (OR=3.74; P=0.012) and atherosclerosis (OR=3.68; P=0.015), after adjustment for age, sex, cardiovascular risk factors, albumin, mineral metabolism markers, CKD stage, lipid lowering drug use, and vitamin D analogues. Receiver operating characteristic (ROC) curves for multivariate regression models to predict carotid atherosclerosis showed that the full model including serum FGF23 had the highest model discrimination (AUC=0.940, 95% CI: 0.900, 0.980, P<0.001). Conclusions: Serum FGF23 is closely associated with dyslipidemia and could become a useful marker for the prediction of carotid atherosclerosis in patients with CKD stages 3-5D.

• 出版日期2017
• 单位上海交通大学