Fibroblast growth factor 23 and cause-specific mortality in the general population: The northern Manhattan study

Nao Souma, Tamara Isakova, David Lipiszko, Ralph L Sacco, Mitchell S V Elkind, Janet T. DeRosa, Shonni J. Silverberg, Armando J Mendez, Chuanhui Dong, Clinton B Wright, Myles Wolf

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Context: An elevated fibroblast growth factor (FGF) 23 is an independent risk factor for cardiovascular disease and mortality in patients with kidney disease. The relationship between FGF23 and cause-specific mortality in the general population is unknown. Objective: To investigate the association of elevated FGF23 with the risk of cause-specific mortality in a racially and ethnically diverse urban general population. Design, Setting, Participants: The Northern Manhattan Study is a population-based prospective cohort study. Residents who were > 39 years old and had no history of stroke were enrolled between 1993 and 2001. Participants with available blood samples for baseline FGF23 testing were included in the current study (n = 2525). Main Outcome Measures: Cause-specific death events. Results: A total of 1198 deaths (474 vascular, 612 nonvascular, 112 unknown cause) occurred during a median follow-up of 14 years. Compared to participants in the lowest FGF23 quintile, those in the highest quintile had a 2.07-fold higher risk (95% confidence interval [CI], 1.45, 2.94) of vascular death and a 1.64-fold higher risk (95% CI, 1.22, 2.20) of nonvascular death in fully adjusted models. Higher FGF23 was independently associated with increased risk of mortality due to cancer, but only in Hispanic participants (hazard ratio per 1 unit increase in ln FGF23 of 1.87; 95% CI, 1.40, 2.50; P for interaction =.01). Conclusions: Elevated FGF23 was independently associated with increased risk of vascular and nonvascular mortality in a diverse general population and with increased risk of cancer death specifically in Hispanic individuals.

Original languageEnglish (US)
Pages (from-to)3779-3786
Number of pages8
JournalJournal of Clinical Endocrinology and Metabolism
Volume101
Issue number10
DOIs
StatePublished - Oct 1 2016

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Mortality
Population
Blood Vessels
Confidence Intervals
Hispanic Americans
Urban Population
Kidney Diseases
fibroblast growth factor 23
Cause of Death
Neoplasms
Cohort Studies
Cardiovascular Diseases
Stroke
Outcome Assessment (Health Care)
Hazards
Prospective Studies
Blood
Testing

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Fibroblast growth factor 23 and cause-specific mortality in the general population : The northern Manhattan study. / Souma, Nao; Isakova, Tamara; Lipiszko, David; Sacco, Ralph L; Elkind, Mitchell S V; DeRosa, Janet T.; Silverberg, Shonni J.; Mendez, Armando J; Dong, Chuanhui; Wright, Clinton B; Wolf, Myles.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 101, No. 10, 01.10.2016, p. 3779-3786.

Research output: Contribution to journalArticle

Souma, Nao ; Isakova, Tamara ; Lipiszko, David ; Sacco, Ralph L ; Elkind, Mitchell S V ; DeRosa, Janet T. ; Silverberg, Shonni J. ; Mendez, Armando J ; Dong, Chuanhui ; Wright, Clinton B ; Wolf, Myles. / Fibroblast growth factor 23 and cause-specific mortality in the general population : The northern Manhattan study. In: Journal of Clinical Endocrinology and Metabolism. 2016 ; Vol. 101, No. 10. pp. 3779-3786.
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abstract = "Context: An elevated fibroblast growth factor (FGF) 23 is an independent risk factor for cardiovascular disease and mortality in patients with kidney disease. The relationship between FGF23 and cause-specific mortality in the general population is unknown. Objective: To investigate the association of elevated FGF23 with the risk of cause-specific mortality in a racially and ethnically diverse urban general population. Design, Setting, Participants: The Northern Manhattan Study is a population-based prospective cohort study. Residents who were > 39 years old and had no history of stroke were enrolled between 1993 and 2001. Participants with available blood samples for baseline FGF23 testing were included in the current study (n = 2525). Main Outcome Measures: Cause-specific death events. Results: A total of 1198 deaths (474 vascular, 612 nonvascular, 112 unknown cause) occurred during a median follow-up of 14 years. Compared to participants in the lowest FGF23 quintile, those in the highest quintile had a 2.07-fold higher risk (95{\%} confidence interval [CI], 1.45, 2.94) of vascular death and a 1.64-fold higher risk (95{\%} CI, 1.22, 2.20) of nonvascular death in fully adjusted models. Higher FGF23 was independently associated with increased risk of mortality due to cancer, but only in Hispanic participants (hazard ratio per 1 unit increase in ln FGF23 of 1.87; 95{\%} CI, 1.40, 2.50; P for interaction =.01). Conclusions: Elevated FGF23 was independently associated with increased risk of vascular and nonvascular mortality in a diverse general population and with increased risk of cancer death specifically in Hispanic individuals.",
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T1 - Fibroblast growth factor 23 and cause-specific mortality in the general population

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AU - Souma, Nao

AU - Isakova, Tamara

AU - Lipiszko, David

AU - Sacco, Ralph L

AU - Elkind, Mitchell S V

AU - DeRosa, Janet T.

AU - Silverberg, Shonni J.

AU - Mendez, Armando J

AU - Dong, Chuanhui

AU - Wright, Clinton B

AU - Wolf, Myles

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Y1 - 2016/10/1

N2 - Context: An elevated fibroblast growth factor (FGF) 23 is an independent risk factor for cardiovascular disease and mortality in patients with kidney disease. The relationship between FGF23 and cause-specific mortality in the general population is unknown. Objective: To investigate the association of elevated FGF23 with the risk of cause-specific mortality in a racially and ethnically diverse urban general population. Design, Setting, Participants: The Northern Manhattan Study is a population-based prospective cohort study. Residents who were > 39 years old and had no history of stroke were enrolled between 1993 and 2001. Participants with available blood samples for baseline FGF23 testing were included in the current study (n = 2525). Main Outcome Measures: Cause-specific death events. Results: A total of 1198 deaths (474 vascular, 612 nonvascular, 112 unknown cause) occurred during a median follow-up of 14 years. Compared to participants in the lowest FGF23 quintile, those in the highest quintile had a 2.07-fold higher risk (95% confidence interval [CI], 1.45, 2.94) of vascular death and a 1.64-fold higher risk (95% CI, 1.22, 2.20) of nonvascular death in fully adjusted models. Higher FGF23 was independently associated with increased risk of mortality due to cancer, but only in Hispanic participants (hazard ratio per 1 unit increase in ln FGF23 of 1.87; 95% CI, 1.40, 2.50; P for interaction =.01). Conclusions: Elevated FGF23 was independently associated with increased risk of vascular and nonvascular mortality in a diverse general population and with increased risk of cancer death specifically in Hispanic individuals.

AB - Context: An elevated fibroblast growth factor (FGF) 23 is an independent risk factor for cardiovascular disease and mortality in patients with kidney disease. The relationship between FGF23 and cause-specific mortality in the general population is unknown. Objective: To investigate the association of elevated FGF23 with the risk of cause-specific mortality in a racially and ethnically diverse urban general population. Design, Setting, Participants: The Northern Manhattan Study is a population-based prospective cohort study. Residents who were > 39 years old and had no history of stroke were enrolled between 1993 and 2001. Participants with available blood samples for baseline FGF23 testing were included in the current study (n = 2525). Main Outcome Measures: Cause-specific death events. Results: A total of 1198 deaths (474 vascular, 612 nonvascular, 112 unknown cause) occurred during a median follow-up of 14 years. Compared to participants in the lowest FGF23 quintile, those in the highest quintile had a 2.07-fold higher risk (95% confidence interval [CI], 1.45, 2.94) of vascular death and a 1.64-fold higher risk (95% CI, 1.22, 2.20) of nonvascular death in fully adjusted models. Higher FGF23 was independently associated with increased risk of mortality due to cancer, but only in Hispanic participants (hazard ratio per 1 unit increase in ln FGF23 of 1.87; 95% CI, 1.40, 2.50; P for interaction =.01). Conclusions: Elevated FGF23 was independently associated with increased risk of vascular and nonvascular mortality in a diverse general population and with increased risk of cancer death specifically in Hispanic individuals.

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