TY - JOUR
T1 - FGF23 modifies the relationship between vitamin D and cardiac remodeling
AU - Ky, Bonnie
AU - Shults, Justine
AU - Keane, Martin G.
AU - Sutton, Martin St John
AU - Wolf, Myles
AU - Feldman, Harold I.
AU - Reese, Peter P.
AU - Anderson, Cheryl A.
AU - Townsend, Raymond R.
AU - Deo, Rajat
AU - Lo, Joan
AU - Gadegbeku, Crystal
AU - Carlow, Dean
AU - Sulik, Michael J.
AU - Leonard, Mary B.
AU - Appel, Lawrence J.
AU - Go, Alan S.
AU - He, Jiang
AU - Kusek, John W.
AU - Lash, James P.
AU - Ojo, Akinlolu
AU - Rahman, Mahboob
PY - 2013/7
Y1 - 2013/7
N2 - Background-There is growing evidence to support an important role for vitamin D and related hormones, parathyroid hormone and fibroblast growth factor 23 (FGF23), on cardiac remodeling in chronic kidney disease. Our objective was to determine the relationships between vitamin D and cardiac remodeling in chronic kidney disease and the effects of parathyroid hormone and FGF23 on these associations. Methods and Results-In 1431 participants from the Chronic Renal Insufficiency Cohort study, we measured 25-hydroxyvitamin D (25(OH)D), 1,25-dihyroxyvitamin D (1,25(OH)2D), FGF23, and parathyroid hormone and performed quantitative echocardiography. Using linear regression methods, we determined significant negative interactions between 25(OH)D and FGF23 on left ventricular (LV) mass (P=0.016), end-diastolic volume (P=0.029), and end-systolic volumes (P=0.021). In participants with an FGF23 level greater than the median of 123.5 RU/mL, each doubling of 25(OH)D was associated with a 2.5% (95% confidence interval, -4.8, -0.2) lower LV mass. This association was less pronounced with FGF23 levels less than the median (0.4%; 95% confidence interval, -1.9, 2.7). Conversely, in participants with deficient 25(OH)D levels <20 ng/mL, each doubling of FGF23 was associated with a 3.4% (95% confidence interval, 1.2, 5.6) greater LV mass compared with only a 1.6% (95% confidence interval, -0.2, 3.5) difference in participants with sufficient 25(OH)D. Similar findings were observed with 25(OH)D and volumes (P<0.05), and 1,25(OH) 2D and LV mass and volumes (P<0.005). There was no effect modification by parathyroid hormone. Conclusions-We identified significant interactions among 25(OH)D, 1,25(OH)2D, and FGF23 on cardiac remodeling. Increased LV mass and cavity dilatation were observed with low 25(OH)D and high FGF23. Our findings suggest that consideration of both hormones is crucial to understanding the role of either in cardiac remodeling, and may have important therapeutic implications.
AB - Background-There is growing evidence to support an important role for vitamin D and related hormones, parathyroid hormone and fibroblast growth factor 23 (FGF23), on cardiac remodeling in chronic kidney disease. Our objective was to determine the relationships between vitamin D and cardiac remodeling in chronic kidney disease and the effects of parathyroid hormone and FGF23 on these associations. Methods and Results-In 1431 participants from the Chronic Renal Insufficiency Cohort study, we measured 25-hydroxyvitamin D (25(OH)D), 1,25-dihyroxyvitamin D (1,25(OH)2D), FGF23, and parathyroid hormone and performed quantitative echocardiography. Using linear regression methods, we determined significant negative interactions between 25(OH)D and FGF23 on left ventricular (LV) mass (P=0.016), end-diastolic volume (P=0.029), and end-systolic volumes (P=0.021). In participants with an FGF23 level greater than the median of 123.5 RU/mL, each doubling of 25(OH)D was associated with a 2.5% (95% confidence interval, -4.8, -0.2) lower LV mass. This association was less pronounced with FGF23 levels less than the median (0.4%; 95% confidence interval, -1.9, 2.7). Conversely, in participants with deficient 25(OH)D levels <20 ng/mL, each doubling of FGF23 was associated with a 3.4% (95% confidence interval, 1.2, 5.6) greater LV mass compared with only a 1.6% (95% confidence interval, -0.2, 3.5) difference in participants with sufficient 25(OH)D. Similar findings were observed with 25(OH)D and volumes (P<0.05), and 1,25(OH) 2D and LV mass and volumes (P<0.005). There was no effect modification by parathyroid hormone. Conclusions-We identified significant interactions among 25(OH)D, 1,25(OH)2D, and FGF23 on cardiac remodeling. Increased LV mass and cavity dilatation were observed with low 25(OH)D and high FGF23. Our findings suggest that consideration of both hormones is crucial to understanding the role of either in cardiac remodeling, and may have important therapeutic implications.
KW - Cardiac remodeling
KW - Echocardiography
KW - Vitamin D
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U2 - 10.1161/CIRCHEARTFAILURE.112.000105
DO - 10.1161/CIRCHEARTFAILURE.112.000105
M3 - Article
C2 - 23748358
AN - SCOPUS:84884730013
SN - 1941-3289
VL - 6
SP - 817
EP - 824
JO - Circulation: Heart Failure
JF - Circulation: Heart Failure
IS - 4
ER -