Fibroblast growth factor 23 and cognitive impairment: The health, aging, and body composition study.

<h4>Background</h4>Concentrations of fibroblast growth factor 23 (FGF-23), a hormone that regulates phosphorus and vitamin D metabolism, increase as kidney function declines. Excess fibroblast growth factor 23 may impact brain function through promotion of vascular disease or through dir...

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Autores principales:	David A Drew, Ronit Katz, Stephen Kritchevsky, Joachim H Ix, Michael Shlipak, Anne B Newman, Andy Hoofnagle, Linda Fried, Orlando M Gutiérrez, Mark Sarnak
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2020
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/375c6c2fe2a7438f8849892530329342
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spelling	oai:doaj.org-article:375c6c2fe2a7438f88498925303293422021-11-25T06:23:48ZFibroblast growth factor 23 and cognitive impairment: The health, aging, and body composition study.1932-620310.1371/journal.pone.0243872https://doaj.org/article/375c6c2fe2a7438f88498925303293422020-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0243872https://doaj.org/toc/1932-6203<h4>Background</h4>Concentrations of fibroblast growth factor 23 (FGF-23), a hormone that regulates phosphorus and vitamin D metabolism, increase as kidney function declines. Excess fibroblast growth factor 23 may impact brain function through promotion of vascular disease or through direct effects on neuronal tissue.<h4>Methods</h4>In the Healthy Aging and Body Composition Study, a longitudinal observational cohort of well-functioning older adults, intact serum FGF-23 was assayed in 2,738 individuals. Cognitive function was assessed at baseline and longitudinally at years 3, 5, and 8 by administration of the Modified Mini Mental State Examination (3MSE), a test of global cognitive function, and the Digit Symbol Substitution Test (DSST), a test primarily of executive function. The associations between FGF-23 and baseline cognitive function and incident cognitive impairment were evaluated using logistic and Poisson regression respectively, and were adjusted for demographics, baseline estimated glomerular filtration rate (eGFR), urine albumin/creatinine ratio, comorbidity, and other measures of mineral metabolism including soluble klotho.<h4>Results</h4>The mean (SD) age was 74(3) years, with 51% female, and 39% black. The median (25th, 75th) FGF-23 concentration was 47 pg/mL (37, 60). Three hundred ninety-two individuals had prevalent cognitive impairment by the 3MSE and 461 by the DSST. There was no observed association between FGF-23 and baseline cognitive function for either cognitive test. There were 277 persons with incident cognitive impairment by 3MSE, and 333 persons with incident cognitive impairment by DSST. In fully adjusted models, each two-fold higher concentration of baseline FGF-23 was not associated with incident cognitive impairment by the 3MSE (IRR = 1.02[0.88, 1.19] fully adjusted model) or by the DSST (IRR = 0.98 [0.84, 1.15]. We saw no difference when analyses were stratified by eGFR greater than or less than 60 ml/min/1.73m2.<h4>Conclusion</h4>Intact FGF-23 was not associated with baseline cognitive function or incident cognitive impairment in this cohort well-functioning older adults.David A DrewRonit KatzStephen KritchevskyJoachim H IxMichael ShlipakAnne B NewmanAndy HoofnagleLinda FriedOrlando M GutiérrezMark SarnakPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 15, Iss 12, p e0243872 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q David A Drew Ronit Katz Stephen Kritchevsky Joachim H Ix Michael Shlipak Anne B Newman Andy Hoofnagle Linda Fried Orlando M Gutiérrez Mark Sarnak Fibroblast growth factor 23 and cognitive impairment: The health, aging, and body composition study.
description	<h4>Background</h4>Concentrations of fibroblast growth factor 23 (FGF-23), a hormone that regulates phosphorus and vitamin D metabolism, increase as kidney function declines. Excess fibroblast growth factor 23 may impact brain function through promotion of vascular disease or through direct effects on neuronal tissue.<h4>Methods</h4>In the Healthy Aging and Body Composition Study, a longitudinal observational cohort of well-functioning older adults, intact serum FGF-23 was assayed in 2,738 individuals. Cognitive function was assessed at baseline and longitudinally at years 3, 5, and 8 by administration of the Modified Mini Mental State Examination (3MSE), a test of global cognitive function, and the Digit Symbol Substitution Test (DSST), a test primarily of executive function. The associations between FGF-23 and baseline cognitive function and incident cognitive impairment were evaluated using logistic and Poisson regression respectively, and were adjusted for demographics, baseline estimated glomerular filtration rate (eGFR), urine albumin/creatinine ratio, comorbidity, and other measures of mineral metabolism including soluble klotho.<h4>Results</h4>The mean (SD) age was 74(3) years, with 51% female, and 39% black. The median (25th, 75th) FGF-23 concentration was 47 pg/mL (37, 60). Three hundred ninety-two individuals had prevalent cognitive impairment by the 3MSE and 461 by the DSST. There was no observed association between FGF-23 and baseline cognitive function for either cognitive test. There were 277 persons with incident cognitive impairment by 3MSE, and 333 persons with incident cognitive impairment by DSST. In fully adjusted models, each two-fold higher concentration of baseline FGF-23 was not associated with incident cognitive impairment by the 3MSE (IRR = 1.02[0.88, 1.19] fully adjusted model) or by the DSST (IRR = 0.98 [0.84, 1.15]. We saw no difference when analyses were stratified by eGFR greater than or less than 60 ml/min/1.73m2.<h4>Conclusion</h4>Intact FGF-23 was not associated with baseline cognitive function or incident cognitive impairment in this cohort well-functioning older adults.
format	article
author	David A Drew Ronit Katz Stephen Kritchevsky Joachim H Ix Michael Shlipak Anne B Newman Andy Hoofnagle Linda Fried Orlando M Gutiérrez Mark Sarnak
author_facet	David A Drew Ronit Katz Stephen Kritchevsky Joachim H Ix Michael Shlipak Anne B Newman Andy Hoofnagle Linda Fried Orlando M Gutiérrez Mark Sarnak
author_sort	David A Drew
title	Fibroblast growth factor 23 and cognitive impairment: The health, aging, and body composition study.
title_short	Fibroblast growth factor 23 and cognitive impairment: The health, aging, and body composition study.
title_full	Fibroblast growth factor 23 and cognitive impairment: The health, aging, and body composition study.
title_fullStr	Fibroblast growth factor 23 and cognitive impairment: The health, aging, and body composition study.
title_full_unstemmed	Fibroblast growth factor 23 and cognitive impairment: The health, aging, and body composition study.
title_sort	fibroblast growth factor 23 and cognitive impairment: the health, aging, and body composition study.
publisher	Public Library of Science (PLoS)
publishDate	2020
url	https://doaj.org/article/375c6c2fe2a7438f8849892530329342
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Fibroblast growth factor 23 and cognitive impairment: The health, aging, and body composition study.

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