title: Serum fibroblast growth factor-23 levels and progression of aortic arch calcification in non-diabetic patients on chronic hemodialysis.
abstract: OBJECTIVE
  Vascular calcification is a cause of cardiovascular death in hemodialysis (HD) patients. The aim of the present study was to evaluate the relationship between the progression of aortic arch calcification (AoAC) and serum fibroblast growth factor (FGF)-23.
  
  
  METHODS
  The enrolled study subjects were 127 (83 men and 44 women) HD patients. Calcification of the aortic arch was semiquantitatively estimated with a score (AoACS) on plain chest radiology. Change in AoACS (ΔAoACS) was obtained by subtracting the baseline AoACS value from the follow-up AoACS value. The second assessment was performed from 5 years after the first determination.
  
  
  RESULTS
  The percentage of male gender in non-progressors (58.5%) was lesser than in regressors (60.0%) and progressors (74.6%). In addition, the dialysis duration in regressors (14.1±5.1 years) was shorter than in non-progressors (19.5±7.0 years) and progressors (16.8±7.5 years). Interestingly, the serum FGF-23 level in regressors (39225.5±9247.9 pg/mL) was significantly higher than in non-progressors (12896.5±26323.5 pg/mL) and progressors (14062.4±18456.8 pg/mL). Multi-ple regression analyses showed male gender (β value=0.969, F=5.092, p=0.0192), serum levels of albumin (β value=-1.395, F=4.541, p=0.0296) and log FGF-23 (β value=-0.001, F=7.273, p=0.0115) to be significant independent determinants of ΔAoACS.
  
  
  CONCLUSIONS
  Changes in AoAC evaluated by using a simple chest radiograph are associated with serum FGF-23 levels. Excess accumulation of FGF-23 in serum may enable to inhibit the calcification process in vessel walls in chronic HD patients.
authors.affiliation: Department of Medicine, Kidney Center, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Tamei
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ogawa
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishida
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Ando
authors.forename: Kosaku
authors.initials: K
authors.lastname: Nitta
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology*; D001018:Aortic Diseases / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology; D002114:Calcinosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology; D002118:Calcium / Q000378:metabolism; D003920:Diabetes Mellitus; D018450:Disease Progression; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D013902:Radiography, Thoracic; D006435:Renal Dialysis / Q000009:adverse effects*
chemical_list: C000717427:FGF23 protein, human; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; D002118:Calcium