58434
document
Low body mass index and dyslipidemia in dialysis patients linked to elevated plasma fibroblast growth factor 23 . BACKGROUND Fibroblast growth factor 23 ( FGF23 ) has been associated with death in dialysis patients . Since FGF23 shares structural features with FGF19 subfamily members that exert hormonal control of fat mass , we hypothesized that high circulating FGF23 concentrations would be associated with the development of a uremic lipid profile and lower body mass index ( BMI ) . METHODS This study was conducted among 654 patients receiving chronic hemodialysis . C-terminal FGF23 concentrations were measured in stored plasma samples . Linear regression was used to examine the cross-sectional associations of plasma FGF23 concentrations with BMI , total cholesterol ( TC ) , low-density lipoprotein-cholesterol ( LDL-C ) , high-density lipoprotein-cholesterol ( HDL-C ) and triglycerides . Cox proportional hazard models were used to examine the association between FGF23 concentrations and all-cause mortality . RESULTS Participants had a mean age of 60 ± 11 years and a median ( IQR ) FGF23 concentration of 4,212 ( 1,411-13,816 ) RU/ml . An increase per SD in log10 FGF23 was associated with lower BMI ( β = -1.11 ; p = 0.008 ) , TC ( β = -6.46 ; p = 0.02 ) , LDL-C ( β = -4.73 ; p = 0.04 ) and HDL-C ( β = -2.14 ; p = 0.03 ) ; after adjusting for age , gender , race , cardiovascular risk factors , serum albumin , markers of mineral metabolism , and use of lipid-lowering drugs . The association of FGF23 with death was attenuated after adjustment for HDL-C ( HR of highest quartile 1.53 , 95 % CI 1.06-2.20 compared to lowest quartile ) . CONCLUSION These results indicate that higher plasma FGF23 levels are associated with lower BMI and dyslipidemia in dialysis patients . The association between FGF23 and death may be mediated through unexplored metabolic risk factors unrelated to mineral metabolism .
58435
Intervention_Physical
dialysis
58436
Intervention_Physical
dialysis
58437
Intervention_Physical
hemodialysis
58438
Intervention_Physical
C-terminal FGF23 concentrations were measured in stored plasma samples
58439
Intervention_Control
Linear regression was used to examine the cross-sectional associations of plasma FGF23 concentrations with BMI
58440
Intervention_Control
total cholesterol ( TC ) , low-density lipoprotein-cholesterol ( LDL-C ) , high-density lipoprotein-cholesterol ( HDL-C ) and triglycerides
58441
Intervention_Other
.
58442
Outcome_Physical
C-terminal FGF23 concentrations
58443
Outcome_Physical
plasma FGF23 concentrations with BMI , total cholesterol ( TC ) , low-density lipoprotein-cholesterol ( LDL-C ) , high-density lipoprotein-cholesterol ( HDL-C ) and triglycerides .