title: Circulating Fibroblast Growth Factor 23 Has a U-Shaped Association With Atrial Fibrillation Prevalence.
abstract: BACKGROUND
  Atrial fibrillation (AF) occurs more frequently among patients with renal dysfunction. We investigated the possible association between prevalence of AF and serum fibroblast growth factor 23 (FGF23), which has been shown to be increased in subjects with renal dysfunction.
  
  
  RESULTS
  Among the total enrollment of 851 cardiac patients, 188 patients had AF (paroxysmal AF, 95; non-paroxysmal AF, 93). Prevalence of AF for FGF23 octile had a U-shaped relationship with the lowest prevalence at the fifth octile. On logistic regression analysis, when the third FGF23 quartile was used as the reference, the first and fourth FGF23 quartiles were associated with prevalence of AF with an odds ratio (OR) of 3.34 (95% confidence interval [CI]: 1.89-5.88) and 2.58 (95% CI: 1.45-4.58), respectively, after adjusting for confounding factors including estimated glomerular filtration rate (eGFR). Among the subgroup of 416 patients for whom serum parathyroid hormone and 25-hydroxy vitamin D data were available, OR of the first and the fourth FGF23 quartile were calculated to be 3.52 and 2.97, respectively, when further adjusted for these two variables in the statistical model.
  
  
  CONCLUSIONS
  Serum FGF23 had a U-shaped relationship with prevalence of AF among Japanese cardiac patients, which was independent of other calcium/phosphate metabolism-related parameters and eGFR. Pathophysiology underlying the observed link, if at all, awaits further investigation.
authors.affiliation: Department of Cardiology, Osaka Medical College.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Miyamura
authors.forename: Shu-ichi
authors.initials: S
authors.lastname: Fujita
authors.forename: Hideaki
authors.initials: H
authors.lastname: Morita
authors.forename: Kazushi
authors.initials: K
authors.lastname: Sakane
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; D044466:Asian People; D001281:Atrial Fibrillation / Q000097:blood* / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood*; D005919:Glomerular Filtration Rate; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007674:Kidney Diseases / Q000097:blood* / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D015995:Prevalence; D012189:Retrospective Studies; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood
chemical_list: C000717427:FGF23 protein, human; D010281:Parathyroid Hormone; D014807:Vitamin D; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; C104450:25-hydroxyvitamin D