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Biomarkers of Mineral and Bone Metabolism and 20-Year Risk of Hospitalization With Infection: The Atherosclerosis Risk in Communities Study.
- Source :
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The Journal of clinical endocrinology and metabolism [J Clin Endocrinol Metab] 2017 Dec 01; Vol. 102 (12), pp. 4648-4657. - Publication Year :
- 2017
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Abstract
- Context: Mineral and bone disorders (MBDs) might be relevant in the etiology of infection.<br />Objective: To determine whether MBD biomarkers were associated with the incidence of hospitalization with infection. We also assessed the cross-sectional association between MBD biomarker levels and kidney function.<br />Design, Setting, Participants: Community-based cohort study of 11,218 participants with an estimated glomerular filtration rate (eGFR) ≥30 mL/min/1.73m2 in the Atherosclerosis Risk in Communities study. We assessed the cross-sectional associations of five MBD markers-fibroblast growth factor 23 (FGF23), 25-hydroxyvitamin D [25(OH)D], parathyroid hormone (PTH), calcium corrected for hypoalbuminemia, and phosphorus-with eGFR from 1990 to 1992 and their longitudinal associations with incident hospitalization with infection in 1990 to 2013.<br />Main Outcome: Incident hospitalization with infection.<br />Results: In age-, sex-, and race-adjusted models, lower eGFRs were significantly associated with greater levels of FGF23, PTH, and corrected calcium but not 25(OH)D or phosphorus. During follow-up, 5078 hospitalizations with infection occurred. In fully adjusted Cox models, with the second quartile as the reference, the hazard ratio (HR) was significantly greater in the highest quartile of FGF23 [HR, 1.12; 95% confidence interval (CI), 1.03 to 1.21], PTH (HR, 1.09; 95% CI, 1.01 to 1.18), and corrected calcium (HR, 1.11; 95% CI, 1.03 to 1.20), and lowest quartile for 25(OH)D (HR, 1.11; 95% CI, 1.03 to 1.21). The association with phosphorus was significant only when the outcome was restricted to primary diagnosis of infection. These findings were consistent across subgroups of age, sex, race, and eGFR (<60 vs ≥60 mL/min/1.73 m2).<br />Conclusions: MBD biomarkers were associated with eGFR and the subsequent risk of infection, supporting MBD involvement in the etiology of infection.<br /> (Copyright © 2017 Endocrine Society)
- Subjects :
- Cohort Studies
Cross-Sectional Studies
Female
Fibroblast Growth Factor-23
Fibroblast Growth Factors blood
Glomerular Filtration Rate
Humans
Incidence
Infections mortality
Longitudinal Studies
Male
Middle Aged
Parathyroid Hormone blood
Prospective Studies
Risk Assessment
Vitamin D analogs & derivatives
Vitamin D blood
Atherosclerosis epidemiology
Biomarkers blood
Bone and Bones metabolism
Hospitalization statistics & numerical data
Infections epidemiology
Minerals metabolism
Subjects
Details
- Language :
- English
- ISSN :
- 1945-7197
- Volume :
- 102
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- The Journal of clinical endocrinology and metabolism
- Publication Type :
- Academic Journal
- Accession number :
- 29029099
- Full Text :
- https://doi.org/10.1210/jc.2017-01868