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논문분류	춘계학술대회 초록집
제목	Fibroblast Growth Factor-23 is Not a Better Marker of Cardiovascular Risk than Phosphate in Patients with Chronic Kidney Disease
저자	Misol LEE1, Ki heon NAM1, Seong yeong AN1, Min-uk CHA1, Hyoungnae KIM1, Seohyun PARK1, Hae-ryong YUN1, Jong hyun JHEE1, Youn kyung KEE1, Tae-ik CHANG2, Jung tak PARK1, Tae-hyun YOO1, Shin-wook KANG1,4, Kyu hun CHOI1, *Seung hyeok HAN1
출판정보	2017; 2017(1):
키워드	Phosphate, fibroblast growth factor 23, cardiovascular risk, chronic kidney disease
초록	Objectives : Elevated circulating fibroblast growth factor 23 (FGF-23) level is commonly seen in chronic kidney disease (CKD) patients. FGF-23 is known as CKD-mineral and bone disorder (CKD-MBD) parameter and has emerged as a key biomarker in predicting the risk for cardiovascular complication in these patients. However, it is unknown whether FGF23 is a better predictor of adverse outcomes than other CKD-MBD parameters. Methods : Using the database from the KoreaN Cohort Study for Outcome in Patients with Chronic Kidney Disease (KNOW-CKD), we explored the association of FGF-23 or serum phosphate with cardiovascular surrogates in 2238 patients with CKD. As cardiovascular surrogates, left ventricular mass index (LVMI) and coronary artery calcium score (CCaS) were measured by echocardiography and multislice computed tomography, respectively. LV hypertrophy (LVH) was defined as a LVMI of > 115 g/m2 for men and >95 g/m2 for women. A CCaS of > 100 was considered the presence of plaque. Results : The mean age was 53.7 ± 12.2 years, and 1,369 (61.2%) patients were male. By Pearson’s correlation coefficient analyses, both serum phosphate and FGF23 well correlated with LVMI and CCaS. In multivariate logistic regression analyses, increased serum phosphate was significantly associated with LVH (odds ratio [OR]=1.67; 95% confidence interval [CI], 1.374-2.040, P<0.001) and CCaS (OR=1.421; 95% CI, 1.146-1.763, P=0.001). In contrast, FGF-23 level was not associated with LVH (OR=1.001; 95% CI, 0.945-1.061, P=0.963) and CCaS (OR=1.021; 95% CI,0.003-0.555, P=0.517). Receiver operator characteristic curve analysis showed that area under the curves (AUCs) for LVH (0.739; 95% CI, 0.712-0.766; P=0.025) and CCaS (0.836; 95% CI, 0.815-0.857; P=0.049) increased after phosphate was added to a conventional model, whereas the AUCs did not increase when FGF23 was added. Conclusions : In this study, FGF-23 has no better association with CV surrogates than serum phosphate and is not helpful for determination of CV risk stratification in CKD patients.
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