Effects of gender and body weight on fibroblast growth factor 23 responsiveness to estimated dietary phosphorus

Ohta, Hiroyuki; Sakuma, Masae; Suzuki, Akitsu; Morimoto, Yuuka; Ishikawa, Makoto; Umeda, Minako; Arai, Hidekazu

doi:10.2152/jmi.63.58

Cited by 3 publications

(2 citation statements)

References 28 publications

(27 reference statements)

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“…Age and gender have also been associated with elevated FGF23 [ 54 ]. However, this association remains controversial [ 55 , 56 ]. The increased FGF23 levels in younger patients may reflect higher protein and phosphate intake.…”

Section: Discussionmentioning

confidence: 99%

Phosphate control in reducing FGF23 levels in hemodialysis patients

et al. 2018

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BackgroundIn hemodialysis patients, high levels of Fibroblast Growth Factor 23 (FGF23) predict mortality. Our study was designed to test whether the control of serum phosphate is associated with a reduction in serum FGF23 levels. Additionally other variables with a potential effect on FGF23 levels were evaluated.Material and methodsThe effect of sustained (40-weeks) control of serum phosphate on FGF23 levels (intact and c-terminal) was evaluated in 21 stable hemodialysis patients that were not receiving calcimimetics or active vitamin D. Patients received non-calcium phosphate binders to maintain serum phosphate below 4.5 mg/dl. In an additional analysis, values of intact-FGF23 (iFGF23) and c-terminal FGF23 (cFGF23) from 150 hemodialysis patients were correlated with parameters of mineral metabolism and inflammation. Linear mixed models and linear regression were performed to evaluate longitudinal trajectories of variables and the association between FGF23 and the other variables examined.ResultsDuring the 40-week treatment, 12 of 21 patients achieved the target of serum phosphate <4.5 mg/dl. In these 12 patients, iFGF23 decreased to less than half whereas cFGF23 did not reduce significantly. In patients with serum phosphate >4.5 mg, iFGF23 and cFGF23 increased two and four-fold respectively as compared with baseline. Furthermore, changes in serum phosphate correlated with changes in C-reactive protein (hs-CRP). In our 150 hemodialysis patients, those in the higher tertile of serum phosphate also showed increased hs-CRP, iPTH, iFGF23 and cFGF23. Multiple regression analysis revealed that iFGF23 levels directly correlated with both serum phosphate and calcium, whereas cFGF23 correlated with serum phosphate and hs-CRP but not with calcium.ConclusionsThe control of serum phosphate reduced iFGF23. This reduction was also associated with a decreased in inflammatory parameters. Considering the entire cohort of hemodialysis patients, iFGF23 levels correlated directly with serum phosphate levels and also correlated inversely with serum calcium concentration. The levels of cFGF23 were closely related to serum phosphate and parameters of inflammation.

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Section: Discussionmentioning

confidence: 99%

Phosphate control in reducing FGF23 levels in hemodialysis patients

et al. 2018

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“…Males had slightly higher (non-significant) FGF-23 levels than females, which is similar to the results in human studies. 17,25,30 Given that the estrogen receptor is located in proximal tubules and is important in regulating the structure and function of kidneys, as well as in Pi excretion, 28 it has been suggested that female hormones could inhibit the action of FGF-23. A previous study 9 reported that the RI for FGF-23 in geriatric cats (median age: 13 y old) was 56–700 pg/mL, which was higher than we observed (0–336 pg/mL).…”

Section: Discussionmentioning

confidence: 99%

Serum fibroblast growth factor 23 (FGF-23): associations with hyperphosphatemia and clinical staging of feline chronic kidney disease

Lin

Chen

et al. 2021

J VET Diagn Invest

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Fibroblast growth factor 23 (FGF-23) is an independent monitor of the progression of chronic kidney disease (CKD) in human medicine, and FGF-23 may have value as a biomarker in feline CKD. We evaluated the relationship between serum FGF-23 and CKD stages, and the effect of age on FGF-23 in normal cats. We measured FGF-23 and intact parathyroid hormone (iPTH) concentrations by ELISA, with intra- and inter-assay CVs ≤ 15%. The percentage recovery of FGF-23 and iPTH remained stable for up to 7 d in samples stored at −20°C and −80°C. We measured FGF-23 in 304 cats, among which 196 were diagnosed with CKD. The 108 clinically healthy cats were divided into 5 subgroups based on growth stage (0–2 y, 3–6 y, 7–10 y, 11–14 y, ≥ 15 y). No statistical difference was found in FGF-23 among age groups ( p = 0.15) or by sex in healthy subjects. Using the International Renal Interest Society guideline, 34 cats were defined as CKD stage 1, 74 stage 2, 51 stage 3, and 37 stage 4. FGF-23 was higher in cats in all CKD stages than in controls. Higher serum phosphorus was observed in stage 3 ( p = 0.04) and 4 ( p < 0.01) compared to controls. iPTH increased as CKD progressed. Pearson analysis indicated a positive linear relationship between FGF-23 and iPTH (control: r = 0.70, p < 0.01; CKD: r = 0.46, p = 0.02). FGF-23 may be a useful biomarker of feline CKD and may precede hyperphosphatemia in advanced feline CKD.

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