An Epidemiological Study On The Relationship Between FGF23 And Arteriosclerosis

Background FGF23 is an important regulator of calcium and phosphorus metabolism.The disorder of calcium and phosphorus metabolism is closely related to arterial calcification and arteriosclerosis.The level of FGF23 is often significantly increased in patients with chronic kidney disease.Some studies on patients with chronic kidney disease have found that FGF23 is associated with arteriosclerosis.However,the relationship between FGF23 and arteriosclerosis in the general populations is not clear,and it is not known whether previous findings that FGF23 promotes arteriosclerosis depending on the level of blood pressure.Objective The present study aims to explore the relationship between FGF23 and arteriosclerosis in the general population and to deeply analyze the relationship between FGF23 and blood pressure and arteriosclerosis,to provide a scientific basis for understanding the relationship between calcium and phosphorus metabolism disorder and arteriosclerosis.Methods From September to November 2018,residents≧18 years old in a community in Dali were invited to participate in this study(the participation rate was 70%).After excluding the subjects with incomplete information or failing to complete the pulse wave velocity measurement,a total of 716 participants were included for statistical analysis.Questionnaires were used to collect information about smoking,drinking,medical history,and drug use.Fasting venous blood samples were collected to detect total cholesterol,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,triglyceride,blood glucose,serum creatinine,uric acid,FGF23,klotho,and so on.The peripheral blood pressure(brachial artery)was measured by mercury sphygmomanometer five times,and the average value was used for statistical analysis.The diagnostic criteria of hypertension are blood pressure≧140/90 mm Hg,or currently taking antihypertensive drugs.Brachial-ankle pulse wave velocity(ba PWV)and ankle-brachial blood pressure index(ABI)were measured by VP-2000.Central arterial blood pressure and carotid-femoral pulse wave velocity(cf PWV)were measured by Sphygmo Cor XCEL.SAS 9.4 and Empower Stats software were used for data management and statistical analysis.Results 1.In this study,the serum FGF23 level showed a skewed distribution,and the logarithmic transformation(Ln FGF23)showed a normal distribution.Spearman correlation analysis showed that serum klotho was the main determinant of serum FGF23.Age,sex,smoking,drinking,body mass index,total cholesterol,triglyceride,uric acid,parathyroid hormone,peripheral mean arterial pressure,fasting blood glucose,creatinine,glycosylated hemoglobin,and insulin levels were not significantly correlated with FGF23 levels.2.The 716 participants were divided into low,middle,and high groups according to the tertiles of serum FGF23.Compared with the lowest tertile group,cf PWV of the middle and highest tertile groups was significantly increased(P < 0.05).There were no significant differences in the proportion of men,smoking and drinking,the prevalence of hypertension,prevalence of diabetes,age,body mass index,total cholesterol,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,triglyceride,fasting blood glucose,glomerular filtration rate,uric acid,peripheral systolic blood pressure,peripheral diastolic blood pressure,central systolic blood pressure,central diastolic blood pressure,ba PWV and ABI among different the FGF23 tertiles.3.Multiple linear regression analysis showed that FGF23 was not significantly correlated to peripheral and central blood pressure whether or not adjusted for age,sex,body mass index,glomerular filtration rate,smoking,drinking,diabetes,antihypertensive treatment.4.Logistic regression analysis showed that body mass index and age were the independent risk factors for hypertension.For every 1 year increase in the age,the risk of hypertension increased by 8% [OR(95%CI)= 1.08(1.06-1.10)];for every 1 kg/m2 increase in body mass index,the risk of hypertension increased by 22% [OR(95%CI)= 1.22(1.15-1.30)].FGF23,smoking,drinking,glomerular filtration rate,uric acid,and total cholesterol were not associated with the risk of hypertension(P>0.05).5.Multiple linear regression analysis showed that after adjusting for covariables,including age,sex,body mass index,glomerular filtration rate,pulse rate,smoking,drinking,diabetes,and antihypertensive treatment,each 2.7-fold increase in serum FGF23 was associated with a 0.1m/s [β(95%CI)= 0.1~0.2] and 18.5cm/s [β(95%CI)= 18.5(1.2~35.9)] increase in cf PWV and ba PWV,respectively.6.There was a significant interaction between FGF23 and diabetes in relation to ba PWV.Only in diabetic patients,serum FGF23 was associated with a higher ba PWV.Conclusions: In this study population,serum FGF23 was positively correlated with cf PWV,which reflects the elasticity of the great arteries.Only in patients with diabetes,FGF23 was independently positively associated with ba PWV,a marker of systemic subclinical atherosclerosis.