title: Association between circulating fibroblast growth factor 23, α-Klotho, and the left ventricular ejection fraction and left ventricular mass in cardiology inpatients.
abstract: BACKGROUND
  Fibroblast growth factor 23 (FGF23), with its co-receptor Klotho, plays a crucial role in phosphate metabolism. Several recent studies suggested that circulating FGF23 and α-Klotho concentrations might be related to cardiovascular abnormalities in patients with advanced renal failure.
  
  
  OBJECTIVE
  Using data from 100 cardiology inpatients who were not undergoing chronic hemodialysis, the association of circulating levels of FGF23, α-Klotho, and other calcium-phosphate metabolism-related parameters with the left ventricular ejection fraction (LVEF) and left ventricular mass (LVM) was analyzed.
  
  
  RESULTS
  LVEF was measured using the modified Simpson method for apical 4-chamber LV images and the LVM index (LVMI) was calculated by dividing the LVM by body surface area. Univariate analysis showed that log transformed FGF23, but not that of α-Klotho, was significantly associated with LVEF and LVMI with a standardized beta of -0.35 (P<0.001) and 0.26 (P<0.05), respectively. After adjusting for age, sex, estimated glomerular filtration rate, and serum concentrations of intact parathyroid hormone, and 25-hydroxyvitamin D as covariates into the statistical model, log-transformed FGF23 was found to be a statistically positive predictor for decreased left ventricular function and left ventricular hypertrophy.
  
  
  CONCLUSIONS
  In cardiology department inpatients, circulating FGF23 concentrations were found to be associated with the left ventricular mass and LVEF independent of renal function and other calcium-phosphate metabolism-related parameters. Whether modulation of circulating FGF23 levels would improve cardiac outcome in such a high risk population awaits further investigation.
authors.affiliation: Department of Cardiology, Osaka Medical College, Osaka, Japan.
authors.forename: Kensaku
authors.initials: K
authors.lastname: Shibata
authors.forename: Shu-Ichi
authors.initials: S
authors.lastname: Fujita
authors.forename: Hideaki
authors.initials: H
authors.lastname: Morita
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Okamoto
authors.forename: Koichi
authors.initials: K
authors.lastname: Sohmiya
authors.forename: Masaaki
authors.initials: M
authors.lastname: Hoshiga
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Ishizaka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002130:Calcium Phosphates / Q000097:blood; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood*; D005966:Glucuronidase / Q000097:blood*; D006331:Heart Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology*; D006801:Humans; D007297:Inpatients; D000090265:Klotho Proteins; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D013318:Stroke Volume; D014463:Ultrasonography
chemical_list: D002130:Calcium Phosphates; C000717427:FGF23 protein, human; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; C020243:calcium phosphate; D005966:Glucuronidase; D000090265:Klotho Proteins
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