THU0121 CIRCULATING FIBROBLAST GROWTH FACTOR-23 IS ASSOCIATED WITH DYSLIPIDEMIA IN RHEUMATOID ARTHRITIS PATIENTS
Authors: Antonio Alvarez de Cienfuegos, Lucia Cantero-Nieto, José Alberto García-Gómez, Gema Robledo, Marta Trigo, Javier Martin Ibanez, Miguel A González-Gay, Norberto Ortego
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Rheumatoid arthritis (RA) patients have an increased risk of morbidity and mortality from cardiovascular (CV) events as a result of accelerated atherosclerosis. The bone-derived fibroblast growth factor-23 (FGF23) is a novel marker of chronic kidney disease (CKD)-associated mineral bone disorder, which increases progressively with declining renal function. FGF23 is associated with left ventricular hypertrophy, impaired left ventricular function, endothelial dysfunction, heart failure and progression of renal failure in adult CKD. <h3>Objectives:</h3> The objectives of this study were to: compare serum FGF-23 levels between<i> RA patients and healthy controls</i> and investigate possible associations between FGF23 as surrogate measures of cardiovascular disease. <h3>Methods:</h3> This cross-sectional study was performed in Vega-Baja Hospital, Orihuela (Spain) from November 2016 to May 2018. We prospectively enrolled 63 consecutive women patients affected by RA and followed at the Vega-Baja Hospital (Orihuela, Spain) and 65 matched healthy women controls. All patients included in this study had normal serum creatinine (Cr) levels and met the 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria for RA. Total cholesterol and triglyceride levels were determined by fully enzymatic techniques. High-density lipoprotein (HDL) was determined after precipitation of apolipoprotein B (apoB)–containing lipoproteins with magnesium sulfate and dextran sulfate. Low-density lipoprotein (LDL) was calculated using the Friedewald formula. Serum FGF-23 was analyzed using ELISA. <h3>Results:</h3> The mean serum total cholesterol, HDL-C, LDL-C, and triglycerides were 212.74±41 mg/dL, 69.92±19.45 mg/dL, 120.18±29.24 mg/dL and 112.93±55.67 mg/dL, respectively. There was no significant differences in FGF-23 levels between the patients and controls [85.7 (5.2-275.4) vs. 81.2 (2.6-269.9), pg/ml; <i>P</i>=0.4316], but we found that FGF23 levels were positively associated with total cholesterol (<i>p</i> &lt;0.05), low-density lipoprotein (LDL-c) level (<i>p</i> &lt;0.05) and smoking (<i>p</i> = 0.008) in patients with RA. <h3>Conclusion:</h3> We report an association between circulating FGF-23 and LDL-c in RA patients, representing a novel pathway linking high FGF23 to an increased cardiovascular risk. <h3>References:</h3> [1] Castañeda S, Nurmohamed MT, González-Gay MA. Cardiovascular disease in inflammatory rheumatic diseases. Best Pract Res Clin Rheumatol. 2016; 30(5):851-869. [2] Kendrick J, Cheung AK, Kaufman JS, Greene T, Roberts WL, Smits G, Chonchol M. FGF-23 associates with death, cardiovascular events, and initiation of chronic dialysis. J Am Soc Nephrol. 2011; 22(10):1913–1922. [3] Scialla JJ, Xie H, Rahman M, Anderson AH, Isakova T, Ojo A, et al. Fibroblast growth factor-23 and cardiovascular events in CKD. J Am Soc Nephrol. 2014; 25(2):349–360. [4] Mirza M, Alsiö J, Hammarstedt A, Erben RG, Michaëlsson K, Å Tivesten Å, et al. Circulating Fibroblast Growth Factor-23 Is Associated With Fat Mass and Dyslipidemia in Two Independent Cohorts of Elderly Individuals. Arterioscler Thromb Vasc Biol. 2011; 31:219-227. <h3>Disclosure of Interests:</h3> Antonio Alvarez de Cienfuegos : None declared, Lucia Cantero-Nieto: None declared, José Alberto García-Gómez: None declared, Gema Robledo: None declared, Marta Trigo: None declared, Javier Martin Ibanez: None declared, Miguel A González-Gay Grant/research support from: Prof. MA Gonzalez-Gay received grants/research supports from Abbvie, MSD, Jansen and Roche., Speakers bureau: Consultation fees/participation in company sponsored speaker's bureau from Pfizer, Lilly, Sobi, Celgene, Novartis, Roche and Sanofi., Norberto Ortego: None declared