title: Fibroblast growth factor is associated to left ventricular mass index, anemia and low values of transferrin saturation.
abstract: BACKGROUND
  Fibroblast growth factor 23 (FGF-23) is a phosphorus-regulating hormone. In chronic kidney disease (CKD), circulating FGF-23 levels are markedly elevated and independently associated with mortality. Left ventricular hypertrophy (LVH) is a potent risk factor for mortality in CKD, and FGFs have been implicated in the pathogenesis of myocardial hypertrophy. In addition, the effect of anemia on CV disease and LVH is well known in CKD. A relation between iron and FGF-23 metabolism is mentioned in a few studies. The aim of this study was to test the association of FGF-23 levels with echocardiographic (ECHO) and iron parameters in peritoneal dialysis patients (PD).
  
  
  METHODS
  In this cross-sectional study, 61 subjects with PD (29 women and 32 men, mean age: 46.9±13.3 years, mean PD vintage: 69.5±39 months) underwent echocardiograms to assess left ventricular mass index (LVMI). Medical treatments and average values of the basic laboratory results of the last 6 months for all patients were recorded. Serum FGF-23 concentrations were measured using intact FGF-23 (iFGF-23) human enzyme-linked immunosorbent assay (ELİSA) kit. According to the median levels of serum FGF-23 the patients were grouped into two (FGF-23 high and low groups).
  
  
  RESULTS
  Significant positive correlation was recorded between serum FGF-23 levels and LVMI (P=0.023). There was also significant difference in terms of hemoglobin (12.1±2 versus 11.0±2, P=0.017), transferrin saturation (TSAT) (24.9±16.8 versus 19.5±10.8, P=0.042) between low and high FGF-23 group. Also in linear regression analysis the negative relation between FGF-23 and hemoglobin is persisted (r=0.199, P=0.045).
  
  
  CONCLUSIONS
  FGF-23 is associated with LVMI, anemia and low TSAT in patients with PD. Whether increased FGF-23 is a marker or a potential mechanism of myocardial hypertrophy and anemia in patients with end-stage renal disease (ESRD) requires further study.
authors.affiliation: Diskapi Yildirim Beyazid Research and Training Hospital, Nephrology Department, Turkey.
authors.forename: Baris
authors.initials: B
authors.lastname: Eser
authors.affiliation: Diskapi Yildirim Beyazid Research and Training Hospital, Nephrology Department, Turkey. Electronic address: ozlemderen@hotmail.com.
authors.forename: Ozlem
authors.initials: O
authors.lastname: Yayar
authors.affiliation: Diskapi Yildirim Beyazid Research and Training Hospital, Nephrology Department, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Buyukbakkal
authors.affiliation: Diskapi Yildirim Beyazid Research and Training Hospital, Nephrology Department, Turkey.
authors.forename: Bulent
authors.initials: B
authors.lastname: Erdogan
authors.affiliation: Diskapi Yildirim Beyazid Research and Training Hospital, Nephrology Department, Turkey.
authors.forename: Zafer
authors.initials: Z
authors.lastname: Ercan
authors.affiliation: Diskapi Yildirim Beyazid Research and Training Hospital, Nephrology Department, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Merhametsiz
authors.affiliation: Diskapi Yildirim Beyazid Research and Training Hospital, Nephrology Department, Turkey.
authors.forename: Ayhan
authors.initials: A
authors.lastname: Haspulat
authors.affiliation: Diskapi Yildirim Beyazid Research and Training Hospital, Nephrology Department, Turkey.
authors.forename: Ebru Gök
authors.initials: EG
authors.lastname: Oğuz
authors.affiliation: Hitit University Nephrology Department, Corum, Turkey.
authors.forename: İbrahim
authors.initials: İ
authors.lastname: Dogan
authors.affiliation: Diskapi Yildirim Beyazid Research and Training Hospital, Nephrology Department, Turkey.
authors.forename: Basol
authors.initials: B
authors.lastname: Canbakan
authors.affiliation: Diskapi Yildirim Beyazid Research and Training Hospital, Nephrology Department, Turkey.
authors.forename: M Deniz
authors.initials: MD
authors.lastname: Ayli
mesh_terms: D000328:Adult; D000740:Anemia / Q000097:blood*; D015415:Biomarkers; D015897:Comorbidity; D004452:Echocardiography; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging; D007501:Iron / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000150:complications / Q000628:therapy; D014168:Transferrin / Q000032:analysis*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology
chemical_list: D015415:Biomarkers; C000717427:FGF23 protein, human; D006454:Hemoglobins; D014168:Transferrin; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; D007501:Iron
keywords: Anemia; Diálisis peritoneal; Factor de crecimiento fibroblástico 23; Fibroblast growth factor 23; Left ventricular mass index; Peritoneal dialysis; Índice de masa ventricular izquierda