| Background:Coronary atherosclerosis,a complex inflammatory disease,which is the pathological basis of most cardiovascular diseases.Coronary atherosclerosis can further narrow and completely occlude coronary arteries.Myocardial ischemia,hypoxia or necrosis leads to a series of cardiovascular events such as coronary artery disease(CAD),due to functional changes in the coronary arteries,which seriously endangers human health and imposes a huge economic burden on society.At present,the diagnosis of coronary heart disease is through coronary angiography,but there is no reliable biochemical test for the severity of coronary atherosclerosis.Fibroblast growth factor 23(FGF23)is a circulating regulator of phosphate and vitamin D metabolism,which is involved in coronary artery calcification and plays an important role in the pathogenesis of cardiovascular disease.This study analyzed the clinical value of the severity of coronary atherosclerosis by measuring the concentration of FGF23 in the circulation.Objective:The purpose of this study was to analyze the clinical value of FGF23 in assessing the severity of coronary atherosclerosis.Methods:In this study,patients with coronary atherosclerosis were enrolled in the Department of Cardiology,Zhongda Hospital,Southeast University,from March 20 to October 2018.The general information of past history,pre-hospital medication,general data and laboratory examinations of the subjects were collected.Coronary heart disease is defined as at least one or more of the main branches of the coronary artery ≥50% according to coronary angiography(CAG)results,and further divided the result into CAD group and non-CAD groups.The Gensini score was used to evaluate the degree of coronary lesions: the lesions were divided into left main artery,left anterior descending artery,left circumflex artery and right coronary artery.The degree of lesions in each vessel was quantitatively assessed,and the final score was the sum of the scores of each branch.The Gensini score is further divided into low,medium,and high groups according to the tertile method.Blood FGF23 levels were determined by Enzyme Linked Immunosorbent Assay(ELISA).The general data and clinical information between the coronary heart disease group and the non-coronary heart disease group were compared.The skewed distribution data were expressed by the median(interquartile range),ie,Md(IQR).The rank sum test was used to compare the concentration of FGF23 between the two groups.Differences were compared between FGF23 and coronary heart disease or FGF23 and Gensini scores by multivariate logistic regression respectively.Results:(1)The concentrations of FGF23 in the coronary heart disease group and the non-coronary heart disease group were 35.66(28.75,61.08)pg/ml and 34.44(24.39,47.46)pg/ml,respectively,with statistical difference(P<0.05).(2)The concentrations of FGF23 in the low,medium and high groups of the Gensini score were 33.66(24.07,45.28)pg/ml,32.63(28.80,58.22)pg/ml,36.96(30.33,62.52)pg/ml,respectively.There was no significant difference between the low group and the medium group(P>0.05).Compared with the low group,the high group FGF23 concentration was higher than the low group,which was statistically different(P<0.01).There was also no statistically significant difference between the high group and the medium group(P>0.05).(3)Multivariate logistic regression analysis showed that there was a correlation between the increase of FGF23 level and the occurrence of coronary heart disease,which was an independent related factor of coronary heart disease.It was adjusted in age,gender,smoking history,history of hypertension,total Total cholesterol(TC),low density lipoprotein(LDL),high density lipoprotein(LDL),blood glucose,hypoglycemic medication history,antihypertensive medication history,lipid-lowering drugs history,there was still a positive correlation between FGF23 and coronary heart disease(OR=1.020,95% CI: 1.006-1.035,P=0.006).The low-group,medium-group and high-group of Gensini scores were analyzed by disordered multi-class logistic regression analysis found that comparison between medium-group and low-group,after the adjustment for age,gender,smoking history,history of hypertension,diabetes,hyperlipidemia,history of hypoglycemic agents,antihypertensive medication,lipid-lowering medication history,FGF23 was still positively correlated with Gensini score(OR=1.027,95% CI: 1.010-1.044,P=0.002).Comparison between high-group and low-group after adjusting for the above factors,FGF23 was still positively correlated with Gensini score(OR=1.030,95% CI: 1.012-1.048,P=0.001),which is an independent positive correlation factor of Gensini score.Conclusions:FGF23 is closely related to the severity of coronary atherosclerotic lesions and is an important factor in coronary heart disease.It is clinically valuable to determine the severity of coronary atherosclerosis by measuring the concentration of FGF23. |
