title: Can fibroblast growth factor (FGF)-23 circulating levels suggest coronary artery abnormalities in children with Kawasaki disease?
abstract: OBJECTIVE
  Kawasaki disease (KD) is an acute self-limited panvasculitis, primarily affecting young children, with an outstanding risk of cardiovascular complications. Fibroblast Growth Factor-23 (FGF23) is the latest member of the FGF family, acting on phosphate metabolism, which has been shown to display a potential role in the vascular remodelling. The aim of our study was to test the hypothesis that circulating serum levels of FGF23 might be related to the occurrence of coronary artery abnormalities (CAA) in children with KD.
  
  
  METHODS
  Serum of 109 consecutive KD patients (median age 30.5 months) were collected for the evaluation of intact FGF23 by ELISA test. Sixty sex/age-matched healthy children were studied as controls, after having excluded rheumatic, endocrinological and chronic renal diseases. In all these subjects a familiar predisposition to atherosclerosis was excluded.
  
  
  RESULTS
  FGF23 levels resulted significantly higher in patients with KD than in controls (72±40 pg/ml vs. 12.3±3.2 pg/ml; p=0.01). Twenty-eight/109 KD patients having developed CAA (aneurysms or dilatations) presented significantly higher FGF23 levels than those without any coronary artery damage (120±40 pg/ml vs. 38.2±5 pg/ml; p<0.0001). Multiple logistic regression analysis showed that only serum FGF23 levels, among different general clinical and biochemical variables, were suggestive of coronary artery damage (OR=4.86).
  
  
  CONCLUSIONS
  Based on this preliminary investigation, high serum FGF23 levels would seem suggestive of the potential occurrence of cardiac vascular complications in children with KD.
authors: Department of Internal Medicine, University of Florence, Italy. l.masi@dmi.unifi.it
authors: Laura
authors: L
authors: Masi
authors: Francesco
authors: F
authors: Franceschelli
authors: Gigliola
authors: G
authors: Leoncini
authors: Alessia
authors: A
authors: Gozzini
authors: Donato
authors: D
authors: Rigante
authors: Francesco
authors: F
authors: La Torre
authors: Marco
authors: M
authors: Matucci-Cerinic
authors: Maria Luisa
authors: ML
authors: Brandi
authors: Fernanda
authors: F
authors: Falcini
mesh_terms: D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002675:Child, Preschool; D003323:Coronary Aneurysm / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood*; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000097:blood* / Q000150:complications; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012307:Risk Factors; D014463:Ultrasonography; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; C000717427:FGF23 protein, human; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23