The Association Of Serum Fibroblast Growth Factor 23 Concentration With Age-related Cardiac Diastolic Function Subclinical State In A Healthy Chinese Population

Objective: To determine the association of serum fibroblast growth factor-23 concentrations with age-related cardiac diastolic function subclinical state and whether this association differs by sex.Methods: 1.Subjects This study is a cross-sectional study based on healthy populations in the community.Select healthy people from 15 communities in Shenyang from January 2014 to February 2015.A total of 716 subjects were enrolled,aged 35-89 years,including 226 males and 339 subjects <60 years old.The study was approved by the Chinese Medical University ethics,and all subjects signed informed consent.Subject: 2.Methods 2.1.Clinical Methods and Laboratory tests General clinical data includes name,age,gender,height,weight and blood pressure.Blood samples were collected from subjects after fasting for at least 12 hours.Partial blood samples were used for biochemical analysis including fasting blood glucose,blood calcium,blood uric acid,urea nitrogen,serum creatinine,triglycerides,total cholesterol,high density lipoprotein cholesterol,and low density lipoprotein cholesterol.Another part of the blood sample were immediately centrifuged,separated into aliquots,and stored at-80°C.Serum FGF-23,CRP and IL-6 were measured by enzyme-linked immunosorbent assay ELISA kits,(USCNK,Wuhan,China),according to the manufacturer's instructions.2.2.Echocardiography All subjects underwent two-dimensional color Doppler and tissue Doppler echocardiography.The left atrial inner diameter(LAD),interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),left ventricular end diastolic volume(LVEDV),early diastolic peak flow velocity(E velocity),left atrial volume index(LAVI),left ventricular mass index(LVMI),left ventricular ejection fraction(LVEF)and E/e' were measured.2.3.Statistical analysis All statistical analyses were performed using SPSS 22.0 statistical software.The Klomogorov-Smimov test was used for normal distribution analysis.The non-normal distribution data was converted into normal distribution data by logarithm.Normally distributed data were expressed as mean ± standard deviation(SD),and the differences in these variables among groups were examined using a one-way analysis of variance(ANOVA).Least-significant Difference(LSD)analysis or Dunnett's T3 analyses were used for comparisons between pairs of groups according to the homogeneity of variance test.The Pearson correlation analysis was used to assess the correlation between two variables.Binary logistic regression analysis were used to adjust for possible confounding variables.P<0.05 was considered statistically significant.Results:1.Serum FGF-23 levels were significantly higher in males than in females(P<0.05).2.Cardiac diastolic function gradually decreased with age and age-related cardiac diastolic function decline of female was significantly higher than males(P<0.01).3.Serum FGF-23 was significantly positively correlated with age(r=0.089,P<0.05)and LAVI(r=0.084,P<0.05)in total while with E/e'(r=0.149,P<0.05)only in males.There was no significant correlation between serum FGF-23 and cardiac diastolic function parameters in females.4.Binary logistic regression analysis showed that median and high FGF-23 were independently associated with age-related cardiac diastolic function decline(OR=2.831,95% CI:1.14~7.009,P=0.024;OR=2.548,95% CI: 1.053~6.163,P=0.038)in males.Conclusion: Higher serum FGF-23 concentrations were associated with age-related cardiac diastolic function subclinical state in a healthy Chinese population.High levels of FGF-23 are independently associated with age-related cardiac diastolic function decline in males.