Abstract P014: Life’S Simple 7 And Fibroblast Growth Factor 23: The Boston Puerto Rican Health Study.

Abstract

Introduction: FGF-23 is a phosphatouric hormone which also serves as a plasma biomarker that mediates pathologic cardiac remodeling, such as left ventricular hypertrophy or myocardial fibrosis, and is associated with increased cardiovascular mortality. However, limited evidence is available on lifestyle-related factors associated with circulating concentration of this emerging cardiovascular risk factor. Objective: Our aim was to measure the association between the American Heart Association’s Life’s Simple 7 (LS7) and circulating FGF-23 concentration among Puerto Rican adults. Methods: Data are from Boston Puerto Rican Health Study (BPRHS) participants (mean age 56.2 years, 77% female) at baseline and at approximately 8-y follow-up (n=410). LS7 was calculated at baseline and includes 4 physiological (BMI, total cholesterol, blood pressure, and fasting glucose) and 3 behavioral factors (smoking, physical activity, and diet). Each component was categorized using a constituent scoring system (ideal=2; intermediate=1; Poor=0) and these were summed to calculate the total LS7 score. Participants were categorized into 5 LS7 groups as follows: 1) score 1-4 (n=105), 2) 5 (n=76), 3) 6 (n=89), 4) 7 (n=69), and 5) 8-12 (n=71). Fasting plasma FGF-23 concentration at 8-y follow-up was measured by ELISA. Associations between baseline LS7 score and 8-y FGF-23 were assessed using ANCOVA, adjusted for age and sex (model 1), and additionally for history of cardiovascular disease and poverty-income-ratio (model 2). Results: Relative to participants in LS7 group 1 (2.98 ± 1.09 mg/dL), those in groups 5 (1.63 ± 1.12 mg/dL, p=0.0001) had significantly lower FGF-23 concentration (model 1, P-trend=0.0001). After considering additional confounders, FGF-23 concentration among LS7 group 5 (1.69 ± 1.12 mg/dL, p=0.0007) remained significantly lower than in group 1 (2.95 ± 1.09 mg/dL). The p-trend across categories was also significant at p=0.0007. In additional analyses, LS7 components for smoking (ideal vs. poor, 2.07 ± 1.10 mg/dL vs. 2.87 ± 1.10 mg/dL, p=0.01) and fasting glucose (ideal vs. poor, 2.03 ± 1.07 mg/dL vs. 2.90 ± 1.09 mg/dL, p=0.004), but no other components, were associated with FGF-23 concentration. Conclusions: Optimal LS7 status was associated with lower 8-y mean plasma FGF-23 concentration. Efforts to target LS7 components, particularly smoking and glucose control, may improve FGF-23 concentration among Puerto Rican adults.