03280nas a2200469 4500008004100000022001400041245013300055210006900188260001300257300001200270490000700282520195800289653000902247653002202256653001702278653001102295653003002306653001802336653001102354653002502365653000902390653001602399653002402415653000902439653002102448100002102469700002102490700002102511700001802532700002002550700002002570700002202590700001602612700001902628700001802647700002202665700002402687700002002711700002402731700001902755856003602774 2013 eng d a1945-719700aFibroblast growth factor 23, bone mineral density, and risk of hip fracture among older adults: the cardiovascular health study.0 aFibroblast growth factor 23 bone mineral density and risk of hip c2013 Aug a3323-310 v983 a
CONTEXT: Fibroblast growth factor 23 (FGF23) is a phosphaturic hormone that also inhibits calcitriol synthesis.
OBJECTIVE: Our objective was to evaluate the relationships of plasma FGF23 concentrations with bone mineral density (BMD) and hip fracture in community-dwelling older adults.
DESIGN AND SETTING: Linear regression and Cox proportional hazard models were used to examine the associations of plasma FGF23 concentrations with BMD and incident hip fracture, respectively. Analyses were also stratified by chronic kidney disease.
PARTICIPANTS: Participants included 2008 women and 1329 men ≥65 years from the 1996 to 1997 Cardiovascular Health Study visit.
MAIN OUTCOME MEASURES: Dual x-ray absorptiometry measured total hip (TH) and lumbar spine (LS) BMD in 1291 participants. Hip fracture incidence was assessed prospectively through June 30, 2008 by hospitalization records in all participants.
RESULTS: Women had higher plasma FGF23 concentrations than men (75 [56-107] vs 66 [interquartile range = 52-92] relative units/mL; P < .001). After adjustment, higher FGF23 concentrations were associated with greater total hip and lumbar spine BMD in men only (β per doubling of FGF23 = 0.02, with 95% confidence interval [CI] = 0.001-0.04 g/cm(2), and 0.03 with 95% CI = 0.01-0.06 g/cm(2)). During 9.6 ± 5.1-11.0 years of follow-up, 328 hip fractures occurred. Higher FGF23 concentrations were not associated with hip fracture risk in women or men (adjusted hazard ratio = 0.95, with 95% CI = 0.78-1.15, and 1.09 with 95% CI = 0.82-1.46 per doubling of FGF23). Results did not differ by chronic kidney disease status (P > .4 for interactions).
CONCLUSIONS: In this large prospective cohort of community-dwelling older adults, higher FGF23 concentrations were weakly associated with greater lumbar spine and total hip BMD but not with hip fracture risk.
10aAged10aAged, 80 and over10aBone Density10aFemale10aFibroblast Growth Factors10aHip Fractures10aHumans10aLongitudinal Studies10aMale10aMiddle Aged10aProspective Studies10aRisk10aSpinal Fractures1 aJovanovich, Anna1 aBůzková, Petra1 aChonchol, Michel1 aRobbins, John1 aFink, Howard, A1 ade Boer, Ian, H1 aKestenbaum, Bryan1 aKatz, Ronit1 aCarbone, Laura1 aLee, Jennifer1 aLaughlin, Gail, A1 aMukamal, Kenneth, J1 aFried, Linda, F1 aShlipak, Michael, G1 aIx, Joachim, H uhttps://chs-nhlbi.org/node/5996