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Kidney Week

Abstract: SA-OR059

High FGF-23 Is Associated with Coronary Calcification Only in Patients with High Adiponectin: From the KNOW-CKD Study

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 303 CKD: Epidemiology, Outcomes - Cardiovascular

Authors

  • Hyun, Young Youl, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea (the Republic of)
  • Oh, Kook-Hwan, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Ahn, Curie, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Kim, Yong-Soo, The Catholic University of Korea College of Medicine, Seoul, Korea (the Republic of)
  • Yoo, Tae-Hyun, Yonsei University College of Medicine, Seoul, Korea (the Republic of)
  • Kim, Soo Wan, Chonnam National University Medical School, Dongku, Korea (the Republic of)
  • Kim, Yeong Hoon, Inje University Medical School, Busan, Korea (the Republic of)

Group or Team Name

  • KNOW-CKD Study Group
Background

Both FGF-23 and coronary artery calcification (CAC) are known as predictors of high cardiovascular and all-cause mortality. However, previous studies on the association between FGF-23 and CAC were inconclusive. Recently, it has been shown that adiponectin modulates renal handling of phosphate and calcium, important factors in vascular calcification. We hypothesized that adiponectin play a role in the effect of FGF-23 on CAC, and explored whether this association between FGF-23 and CAC is modified by serum adiponectin level in CKD patients.

Methods

This cross-sectional study analyzed 1,153 predialysis CKD patients from the KNOW-CKD cohort who measured coronary artery calcium scores (CACS), serum FGF-23 and serum adiponectin. Participants were divided into three groups according to their FGF-23 levels as follows: low <5.0 RU/ml, middle =5.0-29.9 RU/ml, and high ≥30.0 RU/ml. We evaluated the association between FGF-23 and CACS by multivariate Tobit regression and multivariate logistic regression in each group with lower half and upper half of adiponectin.

Results

Median [interquartile range] CACS were not different between low and high adiponectin group (2.0 [0.0-91.8] vs 0.4 [0.0-103.5], P=0.536). The CACS ratio comparing the high FGF-23 to the low FGF-23 was significantly increased in high adiponectin group, but not in low adiponectin group [3.25 (1.53-6.91) vs 1.07 (0.50-2.29), P for interaction=0.029). Similarly, the ORs for CAC in the high FGF-23 group compared to the low group were significantly increased only in the high adiponectin group (Table).

Conclusion

High serum FGF-23 was associated with CAC only in CKD patients with high adiponectin, but not in those with low adiponectin. Further studies are warranted to verify the role of adiponectin in FGF-23-related coronary calcification.

ORs (95% CI) for CAC in different FGF-23 groups according to adiponectin level
 Low adiponectinHigh adiponectinP for interaction
 FGF-23FGF-23 
CAC definitionlow (n=252)
middle (n=202)
high (n=123)
low (n=181)
middle (n=206)
high (n=189)
 
CACS>0reference0.88 (0.54-1.45)
1.11 (0.62-2.02)
reference1.11 (0.67-1.87)
2.15 (1.21-3.80)
0.028
CACS≥100reference0.98 (0.56-1.74)
0.88 (0.45-1.73)
reference1.62 (0.88-2.98)
2.34 (1.24-4.42)
0.070
CACS≥400reference1.25 (0.63-2.48)
0.68 (0.29-1.55)
reference1.65 (0.74-3.67)
4.03 (1.82-8.91)
0.009

Adjusted for age, sex, BMI, hypertension, diabetes, dyslipidemia, current smoking, eGFR, hsCRP, urine protein to creatinine ratio, calcium, phosphorus, ALP, 25-OH-vit D, intact PTH

Funding

  • Government Support - Non-U.S.