title: Plasma fibroblast growth factor 23, parathyroid hormone, 25-hydroxyvitamin D3, and risk of heart failure: a prospective, case-cohort study.
abstract: BACKGROUND
  Bone mineral metabolism may play a role in the development of heart failure (HF).
  
  
  OBJECTIVE
  The aim of the study was to investigate the relationships of plasma fibroblast growth factor (FGF) 23, PTH, and 25-hydroxyvitamin D3 [25(OH)D3] with incident congestive HF in a population-based cohort of men and women aged 40-65 and 35-65 years, respectively, at baseline.
  
  
  METHODS
  We conducted a prospective case-cohort study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam cohort, including a randomly drawn sample of the total cohort free of HF and all incident HF cases that occurred during a mean follow-up of 8.2 ± 1.6 years.
  
  
  METHODS
  A total of 221 incident congestive HF cases and 1228 individuals free of HF were included in the study.
  
  
  METHODS
  Incident congestive HF was measured.
  
  
  RESULTS
  In a multivariable model, each doubling of FGF23 [ie, per log (base 2) unit higher FGF23] was associated with a 29% higher HF risk (hazard ratio, 1.29 [95% confidence interval (CI), 1.07-1.56]). After multivariable adjustment, including estimated glomerular filtration rate, PTH was not related to HF risk (hazard ratio per doubling of PTH, 1.21 [95% CI, 0.99-1.48]). However, an interaction was observed between PTH and obesity, suggesting a relationship with HF risk in obese, but not in nonobese individuals. The hazard ratio for HF per doubling of 25(OH)D3 was 1.02 (95% CI, 0.73-1.41).
  
  
  CONCLUSIONS
  Our findings provide epidemiological evidence for a positive relationship between FGF23 and risk of HF. The role of PTH in the development of HF remains unclear, in particular in obese individuals, until further confirmation in other studies. 25(OH)D3 was not related to HF.
authors.affiliation: Department of Epidemiology (R.d.G., B.B., J.W., M.A., H.B., C.W.), German Institute of Human Nutrition Potsdam-Rehbrücke, D-14558 Nuthetal, Germany; Institute of Agricultural and Nutritional Sciences (F.H., G.I.S.), Human Nutrition Group, Martin-Luther-University Halle-Wittenberg, D-06108 Halle, Germany; Department for Clinical Chemistry and Pathobiochemistry (S.W., B.I.), Otto-von-Guericke-University Magdeburg, 39106 Magdeburg, Germany; Institute of Epidemiology and Social Medicine (H.W.H.), Clinical Epidemiology Unit, University of Münster, D-48129 Münster, Germany; Department of Clinical Medicine (J.D.), University of Bergen, N-5020 Bergen Norway; and Institute for Social Medicine, Epidemiology, and Health Economics (C.W.), Charité University Medical Center, 10117 Berlin, Germany.
authors.forename: Romina
authors.initials: R
authors.lastname: di Giuseppe
authors.forename: Brian
authors.initials: B
authors.lastname: Buijsse
authors.forename: Frank
authors.initials: F
authors.lastname: Hirche
authors.forename: Janine
authors.initials: J
authors.lastname: Wirth
authors.forename: Maria
authors.initials: M
authors.lastname: Arregui
authors.forename: Sabine
authors.initials: S
authors.lastname: Westphal
authors.forename: Berend
authors.initials: B
authors.lastname: Isermann
authors.forename: Hans W
authors.initials: HW
authors.lastname: Hense
authors.forename: Jutta
authors.initials: J
authors.lastname: Dierkes
authors.forename: Heiner
authors.initials: H
authors.lastname: Boeing
authors.forename: Gabriele I
authors.initials: GI
authors.lastname: Stangl
authors.forename: Cornelia
authors.initials: C
authors.lastname: Weikert
mesh_terms: D000328:Adult; D000368:Aged; D001842:Bone and Bones / Q000378:metabolism; D002112:Calcifediol / Q000097:blood*; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood*; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D012307:Risk Factors
chemical_list: C000717427:FGF23 protein, human; D010281:Parathyroid Hormone; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; D002112:Calcifediol