title: Relationship of serum fibroblast growth factor 23 with cardiovascular disease in older community-dwelling women.
abstract: OBJECTIVE
  Although fibroblast growth factor 23 (FGF23) has been implicated in the pathogenesis of cardiovascular disease, the relationship between FGF23 and cardiovascular disease has not been well characterized in the general population. The aim of this study was to determine whether serum FGF23 is independently associated with cardiovascular disease in older community-dwelling women.
  
  
  METHODS
  A cross-sectional design was used to examine the relationship between serum FGF23 and cardiovascular disease. The subjects consisted of a population-based sample of 659 women, aged 70-79 years, who participated in the Women's Health and Aging Studies in Baltimore, Maryland. Prevalent cardiovascular disease (coronary heart disease, stroke, congestive heart failure, and peripheral artery disease) was assessed through diagnostic algorithms and physician adjudication.
  
  
  RESULTS
  Of the 659 women, 185 (28.1%) had cardiovascular disease. Median (25th, 75th percentile) intact serum FGF23 was 34.6 (25.2, 46.2) pg/ml. The prevalence of cardiovascular disease in the lowest, middle, and highest tertile of serum FGF23 was 22.6, 24.9, and 36.7% respectively (P=0.002). Serum log FGF23 was associated with cardiovascular disease (odds ratio per 1 s.d. increase=1.23, 95% confidence interval 1.17, 1.30; P<0.0001) in a multivariable logistic regression model, adjusting for age, race, smoking, education, body mass index, cognition, diabetes, hypertension, physical activity, total cholesterol, high-density lipoprotein cholesterol, and renal function.
  
  
  CONCLUSIONS
  Elevated serum FGF23 concentrations are independently associated with prevalent cardiovascular disease in older community-dwelling women. Further studies are needed to elucidate the potential biological mechanisms by which FGF23 may be involved in the pathogenesis of cardiovascular disease.
authors.affiliation: Department of Ophthalmology, Johns Hopkins University School of Medicine, M015, Smith Building, 400 North Broadway, Baltimore, Maryland 21287, USA.
authors.forename: Mansi
authors.initials: M
authors.lastname: Dalal
authors.forename: Kai
authors.initials: K
authors.lastname: Sun
authors.forename: Anne R
authors.initials: AR
authors.lastname: Cappola
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrucci
authors.forename: Candace
authors.initials: C
authors.lastname: Crasto
authors.forename: Linda P
authors.initials: LP
authors.lastname: Fried
authors.forename: Richard D
authors.initials: RD
authors.lastname: Semba
mesh_terms: D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000096:biosynthesis / Q000097:blood*; D006801:Humans; D012111:Residence Characteristics
chemical_list: D015415:Biomarkers; C000717427:FGF23 protein, human; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23