FGF23 a CV risk factor in former preterm infants

Preterm birth, defined as birth before 37 weeks of gestation, affects around 10.6% of all live births globally (1). Preterm birth has been identified as a significant factor contributing to long-term cardiovascular morbidity and mortality (2). It is associated with an increased risk of elevated blood pressure, hypertension, type 1 and type 2 diabetes, decreased elasticity of the aorta, ischemic heart disease, heart failure, stroke, chronic kidney disease, and cardiovascular mortality during early childhood and young adulthood (3). A recent long-term prospective cohort study has demonstrated a connection between childhood cardiovascular risk factors and adult cardiovascular events (3).

Due to the challenge posed by prematurity and its link to cardiovascular disease, there is a need for biomarkers that can identify individuals at elevated risk, allowing for prompt therapeutic interventions. In adults, fibroblast growth factor-23 (FGF-23) has gained attention as a potential biomarker for cardiovascular disease. Elevated levels of FGF-23 are linked to hypertension, increased left ventricular mass and hypertrophy, as well as a higher incidence of coronary heart disease, heart failure, and overall cardiovascular mortality (4).

In this following pilot study a total number of 26 former very preterm infants (mean gestational age 29.5 weeks) and 21 term-born children (mean gestational age 40.3 weeks), were included. Biomarkers such as FGF23 intact (iFGF23), FGF23 (c-terminal) (cFGF23), Klotho, and HIF-1α were measured in plasma. Significantly higher concentrations were observed only for iFGF-23 and secretoneurin in former very preterm infants in comparison to term-born controls. No differences in HIF-1α, cFGF-23 and α-Klotho were detectable : Young hearts, early risks: novel cardiovascular biomarkers in former very preterm infants at kindergarten age. Mitterer W et al., Pediatr Res. 2024.

 

FGF23 can easily be measured in serum and plasma samples with a conventional ELISA assay:

BIOMEDICA – FGF-23 (intact) ELISA and FGF-23 (C-terminal) multi-matrix ELISA 

 Kit highlights

• Multi-Matrix: works with plasma, serum, and cell culture
• Convenient: 50µl sample/well, all buffers included.
• Reliable: validated quality
• Easy handling: 7 standards and 2 controls
• Comparable: strong correlation with existing methods
• Cited in over 80 publications

 

Literature

1. Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis. Chawanpaiboon S, Vogel JP, Moller AB, Lumbiganon P, Petzold M, Hogan D, Landoulsi S, Jampathong N, Kongwattanakul K, Laopaiboon M, Lewis C, Rattanakanokchai S, Teng DN, Thinkhamrop J, Watananirun K, Zhang J, Zhou W, Gülmezoglu AM. Lancet Glob Health. 2019 Jan;7(1):e37-e46. doi: 10.1016/S2214-109X(18)30451-0. Epub 2018 Oct 30. PMID: 30389451; PMCID: PMC6293055.
2. Mortality Among Young Adults Born Preterm and Early Term in 4 Nordic Nations. Risnes K, Bilsteen JF, Brown P, Pulakka A, Andersen AN, Opdahl S, Kajantie E, Sandin S.JAMA Netw Open. 2021 Jan 4;4(1):e2032779. doi: 10.1001/jamanetworkopen.2020.32779. Erratum in: JAMA Netw Open. 2021 Feb 1;4(2):e210068. doi: 10.1001/jamanetworkopen.2021.0068. PMID: 33416885; PMCID: PMC7794670.
3. Childhood Cardiovascular Risk Factors and Adult Cardiovascular Events. Jacobs DR Jr, Woo JG, Sinaiko AR, Daniels SR, Ikonen J, Juonala M, Kartiosuo N, Lehtimäki T, Magnussen CG, Viikari JSA, Zhang N, Bazzano LA, Burns TL, Prineas RJ, Steinberger J, Urbina EM, Venn AJ, Raitakari OT, Dwyer T.N Engl J Med. 2022 May 19;386(20):1877-1888. doi: 10.1056/NEJMoa2109191. Epub 2022 Apr 4. PMID: 35373933; PMCID: PMC9563825.
4. Fibroblast growth factor-23 and incident coronary heart disease, heart failure, and cardiovascular mortality: the Atherosclerosis Risk in Communities study. Lutsey PL, Alonso A, Selvin E, Pankow JS, Michos ED, Agarwal SK, Loehr LR, Eckfeldt JH, Coresh J J Am Heart Assoc. 2014 Jun 10;3(3):e000936. doi: 10.1161/JAHA.114.000936. PMID: 24922628; PMCID: PMC4309096.