The fibroblast growth factor (FGF) 23 is a hormone-like molecule that secretes from osteoblasts and has the function of suppressing the reabsorption of phosphorus in the distal renal tubule and lowering serum phosphorus. It has been shown that renal dysfunction increases serum FGF23 levels. Although the mechanism remains to be determined, it is also reported that the elevation of serum FGF23 might increase the risk of coronary vascular diseases (CVD). Nevertheless, there are very few reports related to FGF23 in patients with HIV. The goal of the present study was to investigate the relationship between serum FGF23 levels and clinical factors HIV patients.
Male HIV patients who visited the outpatient clinic of Teikyo University Hospital, Tokyo, Japan in 2015 and had been treated with anti-retroviral therapy for more than six months were enrolled. In addition to serum FGF23, clinical factors were also collected, including age, ART regimens, and laboratory data, and Framingham Coronary Heart Disease Risk Score (FHS). To study correlations with FGF23, spearman coefficients was used. To identify factors independently related with FGF23, multiple regression analysis was used.
Sixty-seven patients were enrolled. The median age was 43.7 years old. Median CD4 cell counts was 529/μL, and the median serum FGF 23 level was 36.0 pg/mL. According to spearman coefficients, serum FGF23 levels correlated with HIV RNA > 50 copies (r=0.3911, p=0.0011), serum cystatin C level(r=0.3199, p=0.0097), and some specific anti-HIV drugs; abacavir(ABC)/ lamivudine(3TC) use(r=0.3345, p=0.0057). FHS was not correlated (p=0.9655). According to multiple regression analysis, ABC/3TC use (p=0.00990) and HIV RNA>50 copies (p=0.00002) were significant factors related with the increase of serum FGF23 levels.
Poor virological control and ABC/3TC use were significant factors that elevated serum FGF23 levels. Considering that ABC/3TC is a well-known factor in the increase of the risk of CVD, FGF23 might be one of the factors that increases the risk of CVD in HIV patients receiving ABC/3TC, though FGF23 was not significantly related with FHS in our all study patients.
T. Kitazawa, None
Y. Ota, None
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