Evidence map›Paper›PMID 25563643›Full record

Trial reportStroke2015

Fibroblast growth factor 23 and risk of incident stroke in community-living adults.

Bhupesh Panwar, Nancy S Jenny, Virginia J Howard, Virginia G Wadley, Paul Muntner, Brett M Kissela, Suzanne E Judd, Orlando M Gutiérrez

Open access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Stroke, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
42citing papers in PubMed, 3 pooled it
5.3field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

42 citing papers in PubMed, 3 syntheses or guidelines pooled it, 64 citations in OpenAlex.

  1. Inflammatory cytokines are associated with stroke and risk factors of cerebrovascular diseases: a Mendelian randomization study.Mammalian genome : official journal of the International Mammalian Genome Society · 2025
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Bhupesh PanwarFrom the Departments of Medicine (B.P., V.G.W., P.M., O.M.G.), Epidemiology (V.J.H., P.M., O.M.G.), and Biostatistics (S.E.J.), University of Alabama at Birmingham; Department of Pathology, University of Vermont, Burlington (N.S.J.); and Department of Neurology, University of Cincinnati, OH (B.M.K.).
Nancy S JennyFrom the Departments of Medicine (B.P., V.G.W., P.M., O.M.G.), Epidemiology (V.J.H., P.M., O.M.G.), and Biostatistics (S.E.J.), University of Alabama at Birmingham; Department of Pathology, University of Vermont, Burlington (N.S.J.); and Department of Neurology, University of Cincinnati, OH (B.M.K.).
Virginia J HowardFrom the Departments of Medicine (B.P., V.G.W., P.M., O.M.G.), Epidemiology (V.J.H., P.M., O.M.G.), and Biostatistics (S.E.J.), University of Alabama at Birmingham; Department of Pathology, University of Vermont, Burlington (N.S.J.); and Department of Neurology, University of Cincinnati, OH (B.M.K.).
Virginia G WadleyFrom the Departments of Medicine (B.P., V.G.W., P.M., O.M.G.), Epidemiology (V.J.H., P.M., O.M.G.), and Biostatistics (S.E.J.), University of Alabama at Birmingham; Department of Pathology, University of Vermont, Burlington (N.S.J.); and Department of Neurology, University of Cincinnati, OH (B.M.K.).
Paul MuntnerFrom the Departments of Medicine (B.P., V.G.W., P.M., O.M.G.), Epidemiology (V.J.H., P.M., O.M.G.), and Biostatistics (S.E.J.), University of Alabama at Birmingham; Department of Pathology, University of Vermont, Burlington (N.S.J.); and Department of Neurology, University of Cincinnati, OH (B.M.K.).
Brett M KisselaFrom the Departments of Medicine (B.P., V.G.W., P.M., O.M.G.), Epidemiology (V.J.H., P.M., O.M.G.), and Biostatistics (S.E.J.), University of Alabama at Birmingham; Department of Pathology, University of Vermont, Burlington (N.S.J.); and Department of Neurology, University of Cincinnati, OH (B.M.K.).
Suzanne E JuddFrom the Departments of Medicine (B.P., V.G.W., P.M., O.M.G.), Epidemiology (V.J.H., P.M., O.M.G.), and Biostatistics (S.E.J.), University of Alabama at Birmingham; Department of Pathology, University of Vermont, Burlington (N.S.J.); and Department of Neurology, University of Cincinnati, OH (B.M.K.).
Orlando M GutiérrezFrom the Departments of Medicine (B.P., V.G.W., P.M., O.M.G.), Epidemiology (V.J.H., P.M., O.M.G.), and Biostatistics (S.E.J.), University of Alabama at Birmingham; Department of Pathology, University of Vermont, Burlington (N.S.J.); and Department of Neurology, University of Cincinnati, OH (B.M.K.). ogutierr@uab.edu.
University of Cincinnati · USUniversity of Vermont · US

Funding

VCID and Stroke in a Bi-racial National CohortU01NS041588 · NINDS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI CUSHMAN, MARY, HOWARD, GEORGE · 2002 to 2022
$96.0M
LCenter for Clinical and Translational Science and TrainingUL1TR001425 · NCATS · UNIVERSITY OF CINCINNATI · PI HEUBI, JAMES E., KISSELA, BRETT M · 2015 to 2024
$37.5M
Cincinnati Center for Clinical and Translational Sciences and TrainingUL1TR000077 · NCATS · UNIVERSITY OF CINCINNATI · PI HEUBI, JAMES E., TSEVAT, JOEL · 2012 to 2014
$9.9M
Understanding Cohort Effects on Stroke, VCID, and Cognition After Major Epidemiologic TransitionsR01NS041588 · NINDS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI MARY CUSHMAN, VIRGINIA J. HOWARD · 2001 to 2026
$8.8M
Impact of disordered mineral metabolism on stroke and cognitive impairmentR01NS080850 · NINDS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI GUTIERREZ, ORLANDO M · 2012 to 2016
$1.2M
Phosphorus-based Food Additives, Mineral Metabolism and Cardiovascular HealthR03DK095005 · NIDDK · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI GUTIERREZ, ORLANDO M · 2012 to 2014
$543k
NCATS NIH HHS UL1 TR000077NCATS NIH HHS UL1 TR001425NIDDK NIH HHS R03 DK095005NINDS NIH HHS R01 NS041588NINDS NIH HHS R01 NS080850NINDS NIH HHS R01NS080850NINDS NIH HHS U01 NS041588
6 · The paper itself

Abstract

background and purposeFibroblast growth factor 23 (FGF23) is a hormone that regulates phosphorus and vitamin D metabolism. Elevated FGF23 concentrations are associated with excess risk of cardiovascular disease. Associations of FGF23 with stroke outcomes are less clear.

methodsUsing a case-cohort study design, we examined the association of baseline plasma FGF23 concentrations with incident stroke in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a cohort of black and white adults aged ≥45 years. FGF23 was measured in 615 participants who developed incident stroke (cases) and in 936 participants randomly selected from the REGARDS cohort (comparison subcohort).

resultsIn multivariable-adjusted models, higher calcium and phosphorus concentrations, lower estimated glomerular filtration rate and higher urine albumin excretion were independently associated with higher FGF23. There was no statistically significant association of FGF23 with risk of all-cause stroke in Cox models adjusted for demographic factors and established stroke risk factors (hazard ratio comparing fourth with first quartile 1.19; 95% confidence interval, 0.78-1.82). In prespecified models stratified by stroke subtypes, there was a graded association of FGF23 with risk of cardioembolic stroke in fully adjusted models (quartile 1, reference; quartile 2 hazard ratio, 1.48; 95% confidence interval, 0.63-3.47; quartile 3 hazard ratio, 1.99; 95% confidence interval, 0.89-4.44; quartile 4 hazard ratio, 2.52; 95% confidence interval, 1.08-5.91). There were no statistically significant associations of FGF23 with other ischemic stroke subtypes or with hemorrhagic strokes.

conclusionsHigher FGF23 concentrations were associated with higher risk of cardioembolic but not with other stroke subtypes in community-dwelling adults. Additional studies should delineate reasons for these findings.

Indexed as

Population SurveillanceAgedAged, 80 and overBiomarkersCohort StudiesFemaleFibroblast Growth Factor-23Fibroblast Growth FactorsHumansIncidenceMaleMiddle AgedRisk FactorsStrokeBiomarkersFGF23 protein, humanFibroblast Growth Factor-23Fibroblast Growth Factorscardiovascular diseasefibroblast growth factorsstroke

Identifiers

PMID25563643
PMCPMC4308535
OpenAlexW2043955249

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.