Table 2.
Adjusted association of fibroblast growth factor 23 (FGF23) and serum phosphate with prevalence and severity of coronary artery and thoracic aorta calcification
| Coronary Artery Calcification | Thoracic Aorta Calcification | |||||||
|---|---|---|---|---|---|---|---|---|
| Model* |
Prevalence Prevalence ratio |
p |
Severity† % difference in CAC |
p |
Prevalence Prevalence ratio |
p |
Severity† % difference in TAC |
p |
| Demographic, kidney function adjusted | ||||||||
| Ln FGF23 (per SD‡) | ||||||||
| −Phosphate (n=1434) | 1.05 (1.01 to 1.09) | 0.02 | 5% (−10% to 22%) | 0.57 | 1.02 (0.97 to 1.08) | 0.47 | 30% (8% to 56%) | <0.01 |
| +Phosphate (n=1404) | 1.04 (1.00 to 1.08) | 0.04 | 1% (−13% to 18%) | 0.85 | 1.02 (0.96 to 1.08) | 0.60 | 34% (11% to 62%) | <0.01 |
| Phosphate (per SD‡) | ||||||||
| −FGF23 (n=1404) | 1.09 (1.05 to 1.13) | <0.01 | 37% (19% to 58%) | <0.01 | 1.07 (1.01 to 1.13) | 0.03 | 13% (−5% to 35%) | 0.16 |
| +FGF23 (n=1404) | 1.08 (1.05 to 1.13) | <0.01 | 37% (18% to 58%) | <0.01 | 1.06 (1.00 to 1.13) | 0.03 | 9% (−8% to 30%) | 0.33 |
| + Traditional risk factors | ||||||||
| Ln FGF23 (per SD‡) | ||||||||
| −Phosphate (n=1432) | 1.02 (0.98 to 1.06) | 0.24 | 0% (−14% to 16%) | >0.99 | 1.00 (0.94 to 1.06) | 0.97 | 24% (4% to 48%) | 0.02 |
| +Phosphate (n=1402) | 1.02 (0.98 to 1.06) | 0.32 | −2% (−16% to 14%) | 0.78 | 1.00 (0.94 to 1.05) | 0.90 | 29% (7% to 55%) | <0.01 |
| Phosphate (per SD‡) | ||||||||
| −FGF23 (n=1402) | 1.06 (1.02 to 1.10) | <0.01 | 26% (10% to 46%) | <0.01 | 1.05 (0.99 to 1.11) | 0.09 | 12% (−6% to 34%) | 0.19 |
| +FGF23 (n=1402) | 1.06 (1.02 to 1.10) | <0.01 | 27% (10% to 46%) | <0.01 | 1.05 (0.99 to 1.11) | 0.08 | 9% (−9% to 29%) | 0.35 |
| + Corrected calcium and PTH | ||||||||
| Ln FGF23 (per SD‡) | ||||||||
| −Phosphate (n=1384) | 1.02 (0.99 to 1.07) | 0.22 | 2% (−12% to 18%) | 0.80 | 0.99 (0.94 to 1.05) | 0.84 | 31% (9% to 58%) | <0.01 |
| +Phosphate (n=1372) | 1.02 (0.98 to 1.06) | 0.36 | −1% (−15% to 16%) | 0.93 | 0.99 (0.94 to 1.05) | 0.81 | 31% (9% to 58%) | <0.01 |
| Phosphate (per SD‡) | ||||||||
| −FGF23 (n=1372) | 1.06 (1.02 to 1.10) | <0.01 | 26% (9% to 46%) | <0.01 | 1.04 (0.98 to 1.11) | 0.15 | 12% (−6% to 34%) | 0.21 |
| +FGF23 (n=1372) | 1.06 (1.02 to 1.10) | <0.01 | 26% (9% to 46%) | <0.01 | 1.04 (0.99 to 1.11) | 0.14 | 8% (−10% to 29%) | 0.40 |
Demographic and kidney function adjusted model includes age, sex, race, Hispanic ethnicity, eGFR, ln-transformed urine albumin-to-creatinine ratio and clinical center
+ traditional risk factor model additionally adjusted for prior cardiovascular disease, diabetes, hypertension, hypercholesterolemia, smoking, and categories of body mass index
+ corrected calcium and PTH model additionally adjusted for corrected serum calcium and ln-transformed PTH
+Phosphate is additionally adjusted for serum phosphate
+FGF23 is additionally adjusted for ln-transformed FGF23
among those with non-zero Agatston score (n=920 for CAC; 653 for TAC in demographic and kidney function adjusted model including both serum phosphate and FGF23)
SD of Ln FGF23=0.72; SD of phosphate=0.69