title: Plasma Fibroblast Growth Factor 23: Clinical Correlates and Association With Cardiovascular Disease and Mortality in the Framingham Heart Study.
abstract: Fibroblast growth factor 23 (FGF23) is emerging as a novel biomarker of bone metabolism, chronic kidney disease, and cardiovascular disease (CVD). However, its clinical correlates and potential predictive role in a community-based setting are incompletely understood.
  
  
  
  We evaluated participants of the Framingham Heart Study (seventh examination cycle of the Offspring cohort plus second examination cycle of the multiethnic Omni cohort) to identify clinical correlates of plasma FGF23 (N=3236) and examine its cross-sectional association with vascular function (N=2209), and longitudinal association with 10-year incidence of CVD (N=2823), and all-cause mortality (N=3223).Circulating FGF23 concentrations were positively related to African-American and Asian ethnicity, waist circumference, current smoking, serum glucose, history of CVD, and antihypertensive medication use; and negatively related to male sex, hormone replacement therapy, and estimated glomerular filtration rate. Multivariable-adjusted cross-sectional analyses showed no consistent association of FGF23 with vascular function measures. During a median follow-up time of 10.8 years, 347 incident CVD events and 412 deaths occurred. Multivariable-adjusted Cox regression models revealed a positive association of FGF23 with all-cause mortality (hazard ratio [HR] per SD increase, 1.31; 95% CI, 1.20-1.42), but not with incident CVD (HR per SD increase, 1.05; 95% CI, 0.94-1.17).
  
  
  
  In our large, community-based sample, FGF23 was associated with mortality risk, but not with vascular function or incident CVD.
authors.affiliation: Preventive Medicine and Epidemiology Section, Boston University School of Medicine, Boston, MA European University of Applied Sciences, Faculty of Applied Public Health, Rostock, Germany robin.haring@uni-greifswald.de.
authors.forename: Robin
authors.initials: R
authors.lastname: Haring
authors.affiliation: Department of Biostatistics, Boston University School of Public Health, Boston, MA.
authors.forename: Danielle
authors.initials: D
authors.lastname: Enserro
authors.affiliation: Preventive Medicine and Epidemiology Section, Boston University School of Medicine, Boston, MA National Heart, Lung and Blood Institute's and Boston University's Framingham Heart Study, Framingham, MA.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Xanthakis
authors.affiliation: Cardiovascular Engineering, Inc.,, Norwood, MA.
authors.forename: Gary F
authors.initials: GF
authors.lastname: Mitchell
authors.affiliation: Preventive Medicine and Epidemiology Section, Boston University School of Medicine, Boston, MA Cardiology Section, Evans Department of Medicine, Boston University School of Medicine, Boston, MA Department of Epidemiology, Boston University School of Public Health, Boston, MA National Heart, Lung and Blood Institute's and Boston University's Framingham Heart Study, Framingham, MA.
authors.forename: Emelia J
authors.initials: EJ
authors.lastname: Benjamin
authors.affiliation: Cardiology Section, Evans Department of Medicine, Boston University School of Medicine, Boston, MA.
authors.forename: Naomi M
authors.initials: NM
authors.lastname: Hamburg
authors.affiliation: Department of Biostatistics, Boston University School of Public Health, Boston, MA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Sullivan
authors.affiliation: Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany German Center for Cardiovascular Research (DZHK e.V.), partner site Greifswald, Greifswald, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Nauck
authors.affiliation: Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany.
authors.forename: Henri
authors.initials: H
authors.lastname: Wallaschofski
authors.affiliation: Preventive Medicine and Epidemiology Section, Boston University School of Medicine, Boston, MA Cardiology Section, Evans Department of Medicine, Boston University School of Medicine, Boston, MA Department of Epidemiology, Boston University School of Public Health, Boston, MA National Heart, Lung and Blood Institute's and Boston University's Framingham Heart Study, Framingham, MA.
authors.forename: Ramachandran S
authors.initials: RS
authors.lastname: Vasan
mesh_terms: D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000097:blood* / Q000453:epidemiology / Q000401:mortality; D005260:Female; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood*; D006339:Heart Rate; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D044469:Racial Groups / Q000706:statistics & numerical data; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000097:blood; D055105:Waist Circumference
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; C000717427:FGF23 protein, human; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23
keywords: cardiovascular disease risk factors; epidemiology; metabolism; mineral