Fibroblast growth factor 23, mineral metabolism and mortality among elderly men (Swedish MrOs)

Per Anton Westerberg, Åsa Tivesten, Magnus K. Karlsson, Dan Mellström, Eric Orwoll, Claes Ohlsson, Tobias E. Larsson, Torbjörn Linde, Östen Ljunggren

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background: Fibroblast growth factor 23 (FGF23) is the earliest marker of disturbed mineral metabolism as renal function decreases. Its serum levels are associated with mortality in dialysis patients, persons with chronic kidney disease (CKD) and prevalent cardiovascular disease (CVD), and it is associated with atherosclerosis, endothelial dysfunction and left ventricular hypertrophy in the general population. The primary aim of this study is to examine the association between FGF23 and mortality, in relation to renal function in the community. A secondary aim is to examine the association between FGF23 and CVD related death. Methods. The population-based cohort of MrOS Sweden included 3014 men (age 69-81 years). At inclusion intact FGF23, intact parathyroid hormone (PTH), 25 hydroxyl vitamin D (25D), calcium and phosphate were measured. Mortality data were collected after an average of 4.5 years follow-up. 352 deaths occurred, 132 of CVD. Association between FGF23 and mortality was analyzed in quartiles of FGF23. Kaplan-Meier curves and Log-rank test were used to examine time to events. Cox proportional hazards regression was used to examine the association between FGF23, in quartiles and as a continuous variable, with mortality. The associations were also analyzed in the sub-cohort with estimated glomerular filtration rate (eGFR) above 60 ml/min/1.73 m 2. Results: There was no association between FGF23 and all-cause mortality, Hazard ratio (HR) 95% confidence interval (CI): 1.02 (0.89-1.17). For CVD death the HR (95% CI) was 1.26 (0.99 - 1.59)/(1-SD) increase in log(10)FGF23 after adjustment for eGFR, and other confounders. In the sub-cohort with eGFR > 60 ml/min/1.73 m2 the HR (95% CI) for CVD death was 55% (13-111)/(1-SD) increase in log(10)FGF23. Conclusions: FGF23 is not associated with mortality of all-cause in elderly community living men, but there is a weak association with CVD death, even after adjustment for eGFR and the other confounders. The association with CVD death is noticeable only in the sub-cohort with preserved renal function.

Original languageEnglish (US)
Article number85
JournalBMC Nephrology
Volume14
Issue number1
DOIs
StatePublished - 2013

Fingerprint

Minerals
Mortality
Cardiovascular Diseases
Glomerular Filtration Rate
Confidence Intervals
Kidney
fibroblast growth factor 23
Left Ventricular Hypertrophy
Parathyroid Hormone
Chronic Renal Insufficiency
Sweden
Vitamin D
Hydroxyl Radical
Population
Dialysis
Atherosclerosis
Serum

Keywords

  • Elderly
  • FGF-23
  • FGF23
  • Mineral metabolism
  • Mortality
  • Phosphatonin

ASJC Scopus subject areas

  • Nephrology
  • Medicine(all)

Cite this

Westerberg, P. A., Tivesten, Å., Karlsson, M. K., Mellström, D., Orwoll, E., Ohlsson, C., ... Ljunggren, Ö. (2013). Fibroblast growth factor 23, mineral metabolism and mortality among elderly men (Swedish MrOs). BMC Nephrology, 14(1), [85]. https://doi.org/10.1186/1471-2369-14-85

Fibroblast growth factor 23, mineral metabolism and mortality among elderly men (Swedish MrOs). / Westerberg, Per Anton; Tivesten, Åsa; Karlsson, Magnus K.; Mellström, Dan; Orwoll, Eric; Ohlsson, Claes; Larsson, Tobias E.; Linde, Torbjörn; Ljunggren, Östen.

In: BMC Nephrology, Vol. 14, No. 1, 85, 2013.

Research output: Contribution to journalArticle

Westerberg, PA, Tivesten, Å, Karlsson, MK, Mellström, D, Orwoll, E, Ohlsson, C, Larsson, TE, Linde, T & Ljunggren, Ö 2013, 'Fibroblast growth factor 23, mineral metabolism and mortality among elderly men (Swedish MrOs)', BMC Nephrology, vol. 14, no. 1, 85. https://doi.org/10.1186/1471-2369-14-85
Westerberg, Per Anton ; Tivesten, Åsa ; Karlsson, Magnus K. ; Mellström, Dan ; Orwoll, Eric ; Ohlsson, Claes ; Larsson, Tobias E. ; Linde, Torbjörn ; Ljunggren, Östen. / Fibroblast growth factor 23, mineral metabolism and mortality among elderly men (Swedish MrOs). In: BMC Nephrology. 2013 ; Vol. 14, No. 1.
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abstract = "Background: Fibroblast growth factor 23 (FGF23) is the earliest marker of disturbed mineral metabolism as renal function decreases. Its serum levels are associated with mortality in dialysis patients, persons with chronic kidney disease (CKD) and prevalent cardiovascular disease (CVD), and it is associated with atherosclerosis, endothelial dysfunction and left ventricular hypertrophy in the general population. The primary aim of this study is to examine the association between FGF23 and mortality, in relation to renal function in the community. A secondary aim is to examine the association between FGF23 and CVD related death. Methods. The population-based cohort of MrOS Sweden included 3014 men (age 69-81 years). At inclusion intact FGF23, intact parathyroid hormone (PTH), 25 hydroxyl vitamin D (25D), calcium and phosphate were measured. Mortality data were collected after an average of 4.5 years follow-up. 352 deaths occurred, 132 of CVD. Association between FGF23 and mortality was analyzed in quartiles of FGF23. Kaplan-Meier curves and Log-rank test were used to examine time to events. Cox proportional hazards regression was used to examine the association between FGF23, in quartiles and as a continuous variable, with mortality. The associations were also analyzed in the sub-cohort with estimated glomerular filtration rate (eGFR) above 60 ml/min/1.73 m 2. Results: There was no association between FGF23 and all-cause mortality, Hazard ratio (HR) 95{\%} confidence interval (CI): 1.02 (0.89-1.17). For CVD death the HR (95{\%} CI) was 1.26 (0.99 - 1.59)/(1-SD) increase in log(10)FGF23 after adjustment for eGFR, and other confounders. In the sub-cohort with eGFR > 60 ml/min/1.73 m2 the HR (95{\%} CI) for CVD death was 55{\%} (13-111)/(1-SD) increase in log(10)FGF23. Conclusions: FGF23 is not associated with mortality of all-cause in elderly community living men, but there is a weak association with CVD death, even after adjustment for eGFR and the other confounders. The association with CVD death is noticeable only in the sub-cohort with preserved renal function.",
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AU - Westerberg, Per Anton

AU - Tivesten, Åsa

AU - Karlsson, Magnus K.

AU - Mellström, Dan

AU - Orwoll, Eric

AU - Ohlsson, Claes

AU - Larsson, Tobias E.

AU - Linde, Torbjörn

AU - Ljunggren, Östen

PY - 2013

Y1 - 2013

N2 - Background: Fibroblast growth factor 23 (FGF23) is the earliest marker of disturbed mineral metabolism as renal function decreases. Its serum levels are associated with mortality in dialysis patients, persons with chronic kidney disease (CKD) and prevalent cardiovascular disease (CVD), and it is associated with atherosclerosis, endothelial dysfunction and left ventricular hypertrophy in the general population. The primary aim of this study is to examine the association between FGF23 and mortality, in relation to renal function in the community. A secondary aim is to examine the association between FGF23 and CVD related death. Methods. The population-based cohort of MrOS Sweden included 3014 men (age 69-81 years). At inclusion intact FGF23, intact parathyroid hormone (PTH), 25 hydroxyl vitamin D (25D), calcium and phosphate were measured. Mortality data were collected after an average of 4.5 years follow-up. 352 deaths occurred, 132 of CVD. Association between FGF23 and mortality was analyzed in quartiles of FGF23. Kaplan-Meier curves and Log-rank test were used to examine time to events. Cox proportional hazards regression was used to examine the association between FGF23, in quartiles and as a continuous variable, with mortality. The associations were also analyzed in the sub-cohort with estimated glomerular filtration rate (eGFR) above 60 ml/min/1.73 m 2. Results: There was no association between FGF23 and all-cause mortality, Hazard ratio (HR) 95% confidence interval (CI): 1.02 (0.89-1.17). For CVD death the HR (95% CI) was 1.26 (0.99 - 1.59)/(1-SD) increase in log(10)FGF23 after adjustment for eGFR, and other confounders. In the sub-cohort with eGFR > 60 ml/min/1.73 m2 the HR (95% CI) for CVD death was 55% (13-111)/(1-SD) increase in log(10)FGF23. Conclusions: FGF23 is not associated with mortality of all-cause in elderly community living men, but there is a weak association with CVD death, even after adjustment for eGFR and the other confounders. The association with CVD death is noticeable only in the sub-cohort with preserved renal function.

AB - Background: Fibroblast growth factor 23 (FGF23) is the earliest marker of disturbed mineral metabolism as renal function decreases. Its serum levels are associated with mortality in dialysis patients, persons with chronic kidney disease (CKD) and prevalent cardiovascular disease (CVD), and it is associated with atherosclerosis, endothelial dysfunction and left ventricular hypertrophy in the general population. The primary aim of this study is to examine the association between FGF23 and mortality, in relation to renal function in the community. A secondary aim is to examine the association between FGF23 and CVD related death. Methods. The population-based cohort of MrOS Sweden included 3014 men (age 69-81 years). At inclusion intact FGF23, intact parathyroid hormone (PTH), 25 hydroxyl vitamin D (25D), calcium and phosphate were measured. Mortality data were collected after an average of 4.5 years follow-up. 352 deaths occurred, 132 of CVD. Association between FGF23 and mortality was analyzed in quartiles of FGF23. Kaplan-Meier curves and Log-rank test were used to examine time to events. Cox proportional hazards regression was used to examine the association between FGF23, in quartiles and as a continuous variable, with mortality. The associations were also analyzed in the sub-cohort with estimated glomerular filtration rate (eGFR) above 60 ml/min/1.73 m 2. Results: There was no association between FGF23 and all-cause mortality, Hazard ratio (HR) 95% confidence interval (CI): 1.02 (0.89-1.17). For CVD death the HR (95% CI) was 1.26 (0.99 - 1.59)/(1-SD) increase in log(10)FGF23 after adjustment for eGFR, and other confounders. In the sub-cohort with eGFR > 60 ml/min/1.73 m2 the HR (95% CI) for CVD death was 55% (13-111)/(1-SD) increase in log(10)FGF23. Conclusions: FGF23 is not associated with mortality of all-cause in elderly community living men, but there is a weak association with CVD death, even after adjustment for eGFR and the other confounders. The association with CVD death is noticeable only in the sub-cohort with preserved renal function.

KW - Elderly

KW - FGF-23

KW - FGF23

KW - Mineral metabolism

KW - Mortality

KW - Phosphatonin

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