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Role of fibroblast growth factor-23 in peripheral vascular calcification in non-diabetic and diabetic hemodialysis patients

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Abstract

Introduction:

Fibroblast growth factor (FGF) 23 is a recently identified circulating factor that regulates phosphate (Pi) metabolism. Since the derangement of Pi control is an important risk factor for vascular calcification, we investigated the importance of plasma FGF-23 in the development of vascular calcification in the aorta and peripheral artery in hemodialysis patients with and without diabetes mellitus (DM).

Methods:

Male hemodialysis patients with DM (n=32) and without DM (n=56) were examined. Plasma samples were obtained before the start of dialysis sessions, and the FGF-23 levels were determined by enzyme-linked immunosorbent assay. Roentgenography of the aorta and hand artery was performed, and visible vascular calcification was evaluated by one examiner, who was blinded to the patient characteristics.

Results:

In the 56 non-DM hemodialysis patients, vascular calcification was found in the hand artery in 5 patients (8.9%) and in the aorta in 23 patients (41.1%). These levels were significantly lower (p<0.05) than in the 32 DM patients, of whom, 19 (59.4%) and 21 (65.6%) had vascular calcification of the hand artery and aorta, respectively. Multiple regression analyses performed separately in the non-DM and DM patients showed that the plasma FGF-23 level, Ca×Pi product, and body weight are independent factors significantly associated with hand-artery calcification and that diastolic blood pressure is associated with aorta calcification in non-DM patients. In DM patients, the plasma FGF-23 level and hemodialysis duration emerged as independent factors associated with hand-artery calcification and diastolic blood pressure was associated with aorta calcification. The independent association of the plasma FGF-23 level with hand-artery calcification was retained in both non-DM and DM patients when adjusted for the Ca×Pi product.

Conclusion:

Our findings show that the plasma FGF-23 level is an independent factor negatively associated with peripheral vascular calcification in the hand artery, but not in the aorta, in both male non-DM and DM hemodialysis patients, even when adjusted for the Ca×Pi product. This study raises the possibility that the plasma FGF-23 level may provide a reliable marker for Moenckeberg’s medial calcification in male hemodialysis patients, independent of its regulatory effect on Pi metabolism.

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Authors and Affiliations

  1. Department of Endocrinology, Metabolism, and Molecular Medicine, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan

    M. Inaba, Y. Imanishi, S. Yamada, A. Shioi & Y. Nishizawa

  2. Department of Nephrology, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan

    E. Ishimura

  3. Shirasagi Hospital Kidney Center, Osaka, Japan

    S. Okuno & T. Yamakawa

Authors
  1. M. Inaba
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  2. S. Okuno
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  3. Y. Imanishi
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  4. S. Yamada
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  5. A. Shioi
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  6. T. Yamakawa
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  7. E. Ishimura
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  8. Y. Nishizawa
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Correspondence to M. Inaba.

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Inaba, M., Okuno, S., Imanishi, Y. et al. Role of fibroblast growth factor-23 in peripheral vascular calcification in non-diabetic and diabetic hemodialysis patients. Osteoporos Int 17, 1506–1513 (2006). https://doi.org/10.1007/s00198-006-0154-6

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  • DOI: https://doi.org/10.1007/s00198-006-0154-6

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