Fibroblast growth factor 23, bone mineral density, and risk of hip fracture among older adults

The cardiovascular health study

Anna Jovanovich, Petra Bùžková, Michel Chonchol, John Robbins, Howard A. Fink, Ian H. De Boer, Bryan Kestenbaum, Ronit Katz, Laura D Carbone, Jennifer Lee, Gail A. Laughlin, Kenneth J. Mukamal, Linda F. Fried, Michael G. Shlipak, Joachim H. Ix

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

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) BMDin 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/cm2, 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.

Original languageEnglish (US)
Pages (from-to)3323-3331
Number of pages9
JournalJournal of Clinical Endocrinology and Metabolism
Volume98
Issue number8
DOIs
StatePublished - Aug 1 2013

Fingerprint

Hip Fractures
Bone Density
Minerals
Bone
Health
Independent Living
Plasmas
Spine
Pelvic Bones
Calcitriol
Chronic Renal Insufficiency
Proportional Hazards Models
Linear regression
Hip
Linear Models
Hazards
Hospitalization
X-Rays
Outcome Assessment (Health Care)
fibroblast growth factor 23

ASJC Scopus subject areas

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

Cite this

Fibroblast growth factor 23, bone mineral density, and risk of hip fracture among older adults : The cardiovascular health study. / Jovanovich, Anna; Bùžková, Petra; Chonchol, Michel; Robbins, John; Fink, Howard A.; De Boer, Ian H.; Kestenbaum, Bryan; Katz, Ronit; Carbone, Laura D; Lee, Jennifer; Laughlin, Gail A.; Mukamal, Kenneth J.; Fried, Linda F.; Shlipak, Michael G.; Ix, Joachim H.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 98, No. 8, 01.08.2013, p. 3323-3331.

Research output: Contribution to journalArticle

Jovanovich, A, Bùžková, P, Chonchol, M, Robbins, J, Fink, HA, De Boer, IH, Kestenbaum, B, Katz, R, Carbone, LD, Lee, J, Laughlin, GA, Mukamal, KJ, Fried, LF, Shlipak, MG & Ix, JH 2013, 'Fibroblast growth factor 23, bone mineral density, and risk of hip fracture among older adults: The cardiovascular health study', Journal of Clinical Endocrinology and Metabolism, vol. 98, no. 8, pp. 3323-3331. https://doi.org/10.1210/jc.2013-1152
Jovanovich, Anna ; Bùžková, Petra ; Chonchol, Michel ; Robbins, John ; Fink, Howard A. ; De Boer, Ian H. ; Kestenbaum, Bryan ; Katz, Ronit ; Carbone, Laura D ; Lee, Jennifer ; Laughlin, Gail A. ; Mukamal, Kenneth J. ; Fried, Linda F. ; Shlipak, Michael G. ; Ix, Joachim H. / Fibroblast growth factor 23, bone mineral density, and risk of hip fracture among older adults : The cardiovascular health study. In: Journal of Clinical Endocrinology and Metabolism. 2013 ; Vol. 98, No. 8. pp. 3323-3331.
@article{5c7fa887a32848cabee021f10b15fcaa,
title = "Fibroblast growth factor 23, bone mineral density, and risk of hip fracture among older adults: The cardiovascular health study",
abstract = "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) BMDin 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/cm2, 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.",
author = "Anna Jovanovich and Petra B{\`u}žkov{\'a} and Michel Chonchol and John Robbins and Fink, {Howard A.} and {De Boer}, {Ian H.} and Bryan Kestenbaum and Ronit Katz and Carbone, {Laura D} and Jennifer Lee and Laughlin, {Gail A.} and Mukamal, {Kenneth J.} and Fried, {Linda F.} and Shlipak, {Michael G.} and Ix, {Joachim H.}",
year = "2013",
month = "8",
day = "1",
doi = "10.1210/jc.2013-1152",
language = "English (US)",
volume = "98",
pages = "3323--3331",
journal = "Journal of Clinical Endocrinology and Metabolism",
issn = "0021-972X",
publisher = "The Endocrine Society",
number = "8",

}

TY - JOUR

T1 - Fibroblast growth factor 23, bone mineral density, and risk of hip fracture among older adults

T2 - The cardiovascular health study

AU - Jovanovich, Anna

AU - Bùžková, Petra

AU - Chonchol, Michel

AU - Robbins, John

AU - Fink, Howard A.

AU - De Boer, Ian H.

AU - Kestenbaum, Bryan

AU - Katz, Ronit

AU - Carbone, Laura D

AU - Lee, Jennifer

AU - Laughlin, Gail A.

AU - Mukamal, Kenneth J.

AU - Fried, Linda F.

AU - Shlipak, Michael G.

AU - Ix, Joachim H.

PY - 2013/8/1

Y1 - 2013/8/1

N2 - 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) BMDin 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/cm2, 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.

AB - 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) BMDin 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/cm2, 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.

UR - http://www.scopus.com/inward/record.url?scp=84881503881&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84881503881&partnerID=8YFLogxK

U2 - 10.1210/jc.2013-1152

DO - 10.1210/jc.2013-1152

M3 - Article

VL - 98

SP - 3323

EP - 3331

JO - Journal of Clinical Endocrinology and Metabolism

JF - Journal of Clinical Endocrinology and Metabolism

SN - 0021-972X

IS - 8

ER -