J Clin Neurol.  2020 Jan;16(1):29-36. 10.3988/jcn.2020.16.1.29.

Plasma Fibroblast Growth Factor 23 Concentration Is Associated with Intracranial Cerebral Atherosclerosis in Acute Ischemic Stroke Patients

• Chang Y
• Kim J
• Woo HG
• Ryu DR
• Oh HJ
• Song TJ

• KMID: 2467781
• DOI: http://doi.org/10.3988/jcn.2020.16.1.29

Abstract

BACKGROUND AND PURPOSE
Fibroblast growth factor 23 (FGF23) is associated with atherosclerosis via nitric-oxide-associated endothelial dysfunction and calcium-phosphate-related bone mineralization. This study aimed to determine the association of the plasma FGF23 concentration with intracranial cerebral atherosclerosis (ICAS) and extracranial cerebral atherosclerosis (ECAS).
METHODS
We prospectively enrolled 262 first-ever ischemic stroke patients in whom brain magnetic resonance was performed and a blood sample acquired within 24 h after admission. Plasma FGF23 concentrations were measured using an enzyme-linked immunosorbent assay. The presence of ICAS or ECAS was defined as a ≥50% decrease in arterial diameter in magnetic resonance angiography. The burden of cerebral atherosclerosis was calculated by adding the total number of vessels defined as ICAS or ECAS.
RESULTS
Our study population included 152 (58.0%) males. The mean age was 64.7 years, and the plasma FGF23 concentration was 347.5±549.6 pg/mL (mean±SD). ICAS only, ECAS only, and both ICAS and ECAS were present in 31.2% (n=82), 4.9% (n=13), and 6.8% (n=18) of the subjects, respectively. In multivariate binary and ordinal logistic analyses, after adjusting for sex, age, and variables for which p < 0.1 in the univariate analysis, the plasma FGF23 concentration (per 100 pg/mL) was positively correlated with the presence of ICAS [odds ratio (OR)=1.07, 95% CI=1.00-1.15, p=0.039], burden of ICAS (OR=1.09, 95% CI=1.04-1.15, p=0.001), and burden of ECAS (OR=1.06, 95% CI=1.00-1.12, p=0.038), but it was not significantly related to the presence of ECAS (OR=1.05, 95% CI=0.99-1.12, p=0.073).
CONCLUSIONS
The plasma FGF23 may be a potential biomarker for cerebral atherosclerosis, particularly the presence and burden of ICAS in stroke patients.

Keyword

fibroblast growth factor 23; Klotho; cerebral atherosclerosis; intracranial atherosclerosis

MeSH Terms

Atherosclerosis
Brain
Calcification, Physiologic
Enzyme-Linked Immunosorbent Assay
Fibroblast Growth Factors*
Fibroblasts*
Humans
Intracranial Arteriosclerosis*
Magnetic Resonance Angiography
Male
Plasma*
Prospective Studies
Stroke*
Fibroblast Growth Factors

Figure

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  Fig. 1 Flowchart of participants according to inclusion and exclusion criteria.

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  Fig. 2 Association of FGF23 with the burden of ICAS (A) and the burden of ECAS (B). X-axis indicates the burden of each type of cerebral atherosclerosis, and Y-axis indicates the value of natural logarithm of FGF23. ECAS: extracranial cerebral atherosclerosis, FGF23: fibroblast growth factor 23, ICAS: intracranial cerebral atherosclerosis.

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