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Fibroblast Growth Factor 23 Is Associated with Chronic Obstructive Pulmonary Disease Exacerbations: A Pilot Study
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A4755 - Fibroblast Growth Factor 23 Is Associated with Chronic Obstructive Pulmonary Disease Exacerbations: A Pilot Study
Author Block: S. Gulati1, G. P. Urdaneta2, K. Balestrini2, I. Vital2, M. Campos2, S. Krick1; 1Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States, 2Pulmonary Section, Miami VA Medical Center, Miami, FL, United States.
Introduction: Elevations in circulating levels of the phosphaturic hormone, fibroblast growth factor (FGF) 23, are associated with systemic inflammation and increased mortality in chronic kidney disease. Klotho is a co-receptor of FGF23 and klotho deficient mice have elevated FGF23 levels, develop spontaneous pulmonary emphysema and obstructive changes consistent with chronic obstructive pulmonary disease (COPD). Plasma FGF 23 is also elevated in smokers and individuals with COPD. However, it is not clear whether FGF23 contributes to the pathophysiology of lung disease. The aim of our study is to explore the association between FGF23 levels and various COPD disease characteristics.
Methods: The study was conducted at the Miami VA Medical Center. Patients with a pre-existing diagnosis of COPD were enrolled between June 2016 and December 2016 while in their stable state during their routine follow up visit. Plasma samples were analyzed for FGF 23 levels using an enzyme-linked immunosorbent assay (ELISA) from Immutopics (Athens, OH, USA). Information about demographic variables, medications and history of COPD exacerbations in the preceding year was extracted from questionnaires and medical chart review.
Results: The 70 patients included for analysis were 69±6 years old, 94% males, with an FEV1 46.5 ±15.5 predicted, and 74% were current smokers. Plasma FGF 23 levels were elevated in the whole cohort (56.5±35.2 pg/ml). FGF 23 levels were highest in patients with ≥ 3 exacerbations per year and lowest in patients with no exacerbations (104.8 ± 45.1 pg/ml vs 49.4 ± 25.6 pg/ml, p = 0.019). Higher FGF 23 levels were also associated with increased exacerbation frequency (beta coefficient 12.68, p = 0.017) when adjusted for age, gender, smoking status and FEV1 using linear regression.
Conclusion: To our knowledge, this is the first study showing a linear relationship between FGF 23 levels and COPD exacerbation frequency independent of age, gender, smoking status and spirometric indices. Further studies are needed to explore the role of FGF 23 as a potential biomarker in “COPD frequent exacerbator phenotype”.
Author Block: S. Gulati1, G. P. Urdaneta2, K. Balestrini2, I. Vital2, M. Campos2, S. Krick1; 1Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL, United States, 2Pulmonary Section, Miami VA Medical Center, Miami, FL, United States.
Introduction: Elevations in circulating levels of the phosphaturic hormone, fibroblast growth factor (FGF) 23, are associated with systemic inflammation and increased mortality in chronic kidney disease. Klotho is a co-receptor of FGF23 and klotho deficient mice have elevated FGF23 levels, develop spontaneous pulmonary emphysema and obstructive changes consistent with chronic obstructive pulmonary disease (COPD). Plasma FGF 23 is also elevated in smokers and individuals with COPD. However, it is not clear whether FGF23 contributes to the pathophysiology of lung disease. The aim of our study is to explore the association between FGF23 levels and various COPD disease characteristics.
Methods: The study was conducted at the Miami VA Medical Center. Patients with a pre-existing diagnosis of COPD were enrolled between June 2016 and December 2016 while in their stable state during their routine follow up visit. Plasma samples were analyzed for FGF 23 levels using an enzyme-linked immunosorbent assay (ELISA) from Immutopics (Athens, OH, USA). Information about demographic variables, medications and history of COPD exacerbations in the preceding year was extracted from questionnaires and medical chart review.
Results: The 70 patients included for analysis were 69±6 years old, 94% males, with an FEV1 46.5 ±15.5 predicted, and 74% were current smokers. Plasma FGF 23 levels were elevated in the whole cohort (56.5±35.2 pg/ml). FGF 23 levels were highest in patients with ≥ 3 exacerbations per year and lowest in patients with no exacerbations (104.8 ± 45.1 pg/ml vs 49.4 ± 25.6 pg/ml, p = 0.019). Higher FGF 23 levels were also associated with increased exacerbation frequency (beta coefficient 12.68, p = 0.017) when adjusted for age, gender, smoking status and FEV1 using linear regression.
Conclusion: To our knowledge, this is the first study showing a linear relationship between FGF 23 levels and COPD exacerbation frequency independent of age, gender, smoking status and spirometric indices. Further studies are needed to explore the role of FGF 23 as a potential biomarker in “COPD frequent exacerbator phenotype”.
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