成纤维细胞生长因子23与心房颤动的相关性

Relationship between circulating fibroblast growth factor-23 and incidence of atrial fibrillation

目的评价无慢性肾脏疾病(chronic kidney disease,CKD)人群成纤维细胞生长因子-23(fibroblast growth factor 23,FGF-23)水平与新发心房颤动(new-onset atrial fibrillation,NAF)的相关性。方法连续入选2012-01至2015-12在北京总队医院体检的1152例非心房颤动(Atrial fibrillation,AF)受检者;记录基线资料,检测其基线FGF-23水平;随访所有研究对象,记录3年内NAF事件;多因素回归分析评估基线FGF-23水平与NAF的关系。结果1152例平均56.6岁,男509例(44.2%),共35例发生NAF(3.0%)。根据FGF-23水平将所有研究对象分为4组,FGF-23水平较高组男性比例、体质量指数、高血压、糖尿病、冠状动脉疾病、左室肥厚所占比例均较高,eGFR水平较低,而血磷、PTH水平偏高(P均<0.05)。FGF-23高水平组NAF发生率明显高于低水平组(P<0.05)。在校正人口学资料、合并疾病、矿物质代谢指标及超声参数后,以FGF-23水平最低组作为对照,FGF-23水平最高组发生NAF的风险为1.61(95%CI:1.03~2.53,P<0.05)。结论在无CKD的人群中,高水平FGF-23与NAF发生独立相关。

Objective To investigate whether the concentration of circulating fibroblast growth factor 23(FGF-23)is associated with new-onset atrial fibrillation(NAF)in general populations without chronic kidney disease(CKD).Methods A total of 1152 health checkup examinees who were free of CKD and atrial arrhythmia were selected between January 2012 and December 2015.Serum intact FGF-23 concentrations were measured using the Kainos 2-site ELISA method.NAF was diagnosed according to ECGs and hospital discharge records.All the subjects were followed up for three years.Multivariate logistic regression analysis was used to estimate the association between FGF-23 and NAF.Results The average age of these subjects was 56.6±5.7 years.44.2%(509)of them were males and 35 of them(3.0%)developed NAF during follow-up.These subjects were divided into four groups according to their FGF-23 levels.Elder males were more likely to have higher levels of FGF-23,who tended to have higher BMI,lower eGFR and higher serum phosphorus and PTH levels,and were more vulnerable to hypertension,diabetes mellitus,coronary artery disease,and left ventricular hypertrophy(LVH)(P<0.05).According to multivariable analysis,a higher baseline FGF-23 level was found to be associated with the risk of NAF(P<0.05).Conclusions Higher serum FGF-23 concentrations are associated with NAF in general populations without CKD.