Plasma fibroblast growth factor 23 concentration is associated with intracranial cerebral atherosclerosis in acute ischemic stroke patients

Yoonkyung Chang, Jinkwon Kim, Ho Geol Woo, Dong Ryeol Ryu, Hyung Jung Oh, Tae Jin Song

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Background and Purpose Fibroblast growth factor 23 (FGF23) is associated with atherosclerosis via nitric-oxide-associated endothelial dysfunction and calcium-phosphate-related bone mineralization. This study aimed to determine the association of the plasma FGF23 concentration with intracranial cerebral atherosclerosis (ICAS) and extracranial cerebral atherosclerosis (ECAS). Methods We prospectively enrolled 262 first-ever ischemic stroke patients in whom brain magnetic resonance was performed and a blood sample acquired within 24 h after admission. Plasma FGF23 concentrations were measured using an enzyme-linked immunosorbent assay. The presence of ICAS or ECAS was defined as a ≥50% decrease in arterial diameter in magnetic resonance angiography. The burden of cerebral atherosclerosis was calculated by adding the total number of vessels defined as ICAS or ECAS. Results Our study population included 152 (58.0%) males. The mean age was 64.7 years, and the plasma FGF23 concentration was 347.5±549.6 pg/mL (mean±SD). ICAS only, ECAS only, and both ICAS and ECAS were present in 31.2% (n=82), 4.9% (n=13), and 6.8% (n=18) of the subjects, respectively. In multivariate binary and ordinal logistic analyses, after adjusting for sex, age, and variables for which p<0.1 in the univariate analysis, the plasma FGF23 concentration (per 100 pg/mL) was positively correlated with the presence of ICAS [odds ratio (OR)=1.07, 95% CI=1.00–1.15, p=0.039], burden of ICAS (OR=1.09, 95% CI=1.04–1.15, p=0.001), and burden of ECAS (OR=1.06, 95% CI=1.00–1.12, p=0.038), but it was not significantly related to the presence of ECAS (OR=1.05, 95% CI=0.99–1.12, p=0.073). Conclusions The plasma FGF23 may be a potential biomarker for cerebral atherosclerosis, particularly the presence and burden of ICAS in stroke patients.

Original languageEnglish
Pages (from-to)29-36
Number of pages8
JournalJournal of Clinical Neurology (Korea)
Issue number1
StatePublished - Jan 2020

Bibliographical note

Funding Information:
This project was supported by grant from the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education (2018R1D1A1B07040959 to T-JS).

Publisher Copyright:
© 2020 Korean Neurological Association.


  • Cerebral atherosclerosis
  • Intracranial atherosclerosis
  • Klotho
  • ‌fibroblast growth factor 23


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