title: Fibroblast growth factor 23, left ventricular mass, and left ventricular hypertrophy in community-dwelling older adults.
abstract: OBJECTIVE
  In chronic kidney disease (CKD), high FGF23 concentrations are associated with left ventricular hypertrophy (LVH), cardiovascular events, and death. The associations of FGF23 with left ventricular mass (LVM) and LVH in the general population and the influence of CKD remains uncertain.
  
  
  METHODS
  C-terminal plasma FGF23 concentrations were measured, and LVM and LVH evaluated by echocardiogram among 2255 individuals ≥65 years in the Cardiovascular Health Study. Linear regression analysis adjusting for demographics, cardiovascular, and kidney related risk factors examined the associations of FGF23 concentrations with LVM. Analyses were stratified by CKD status and adjusted linear and logistic regression analysis explored the associations of FGF23 with LVM and LVH.
  
  
  RESULTS
  Among the entire cohort, higher FGF23 concentrations were associated with greater LVM in adjusted analyses (β = 6.71 [95% CI 4.35-9.01] g per doubling of FGF23). 32% (n = 624) had CKD (eGFR <60 mL/min/1.73 m(2) and/or urine albumin-to-creatinine ratio >30 mg/g). Associations were stronger among participants with CKD (p interaction = 0.006): LVM β = 9.71 [95% CI 5.86-13.56] g per doubling of FGF23 compared to those without CKD (β = 3.44 [95% CI 0.77, 6.11] g per doubling of FGF23). While there was no significant interaction between FGF23 and CKD for LVH (p interaction = 0.25), the OR (1.46 95% CI [1.20-1.77]) in the CKD group was statistically significant and of larger magnitude than the OR for in the no CKD group (1.12 [95% CI 0.97-1.48]).
  
  
  CONCLUSIONS
  In a large cohort of older community-dwelling adults, higher FGF23 concentrations were associated with greater LVM and LVH with stronger relationships in participants with CKD.
authors.affiliation: Division of Renal Diseases and Hypertension, University of Colorado Denver, Mail Stop C281, 12700 E. 19th Ave, Room 7C03-A, Aurora, CO 80045, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Jovanovich
authors.forename: Joachim H
authors.initials: JH
authors.lastname: Ix
authors.forename: John
authors.initials: J
authors.lastname: Gottdiener
authors.forename: Kim
authors.initials: K
authors.lastname: McFann
authors.forename: Ronit
authors.initials: R
authors.lastname: Katz
authors.forename: Bryan
authors.initials: B
authors.lastname: Kestenbaum
authors.forename: Ian H
authors.initials: IH
authors.lastname: de Boer
authors.forename: Mark
authors.initials: M
authors.lastname: Sarnak
authors.forename: Michael G
authors.initials: MG
authors.lastname: Shlipak
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Mukamal
authors.forename: David
authors.initials: D
authors.lastname: Siscovick
authors.forename: Michel
authors.initials: M
authors.lastname: Chonchol
mesh_terms: D000368:Aged; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood*; D006352:Heart Ventricles / Q000473:pathology*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000473:pathology*; D008137:Longitudinal Studies; D008297:Male; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D012307:Risk Factors; D014463:Ultrasonography
chemical_list: C000717427:FGF23 protein, human; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23
keywords: Cardiovascular disease; Chronic kidney disease; Fibroblast growth factor 23; Left ventricular hypertrophy; Left ventricular mass; Older adults