Interactions between FGF23 and vitamin D

Razzaque, Mohammed S

doi:10.1530/ec-22-0239

Cited by 14 publications

(12 citation statements)

References 72 publications

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“…PTH causes bone resorption. While FGF23 promotes urinary phosphate excretion, inhibition of 1-αhydroxylase causes a decrease in 1,25-dihydroxvitamin D levels [ 43 ]. The decrease in blood sodium concentration can also directly affect osteoclasts, leading to an increase in bone fragility [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of sodium-glucose cotransporter 2 inhibitors on bone metabolism in patients with type 2 diabetes mellitus: a systematic review and meta-analysis

Wang,

Li,

et al. 2024

BMC Endocr Disord

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Background Sodium glucose cotransporter 2 (SGLT2) inhibitors are widely used in type 2 diabetes mellitus (T2DM) therapy. The impact of SGLT2 inhibitors on bone metabolism has been widely taken into consideration. But there are controversial results in the study on the effect of SGLT2 inhibitors on bone metabolism in patients with T2DM. Therefore, we aimed to examine whether and to what extent SGLT2 inhibitors affect bone metabolism in patients with T2DM. Methods A literature search of randomized controlled trials (RCTs) was conducted through PubMed, Web of Science, Embase, Cochrane databases, and Scopus from inception until 15 April 2023. Eligible RCTs compared the effects of SGLT2 inhibitors versus placebo on bone mineral density and bone metabolism in patients with T2DM. To evaluate the differences between groups, a meta-analysis was conducted using the random effects inverse-variance model by utilizing standardized mean differences (SMD). Results Through screening, 25 articles were finally included, covering 22,828 patients. The results showed that, compared with placebo, SGLT2 inhibitors significantly increased parathyroid hormone (PTH, SMD = 0.13; 95%CI: 0.06, 0.20), and cross-linked C-terminal telopeptides of type I collagen (CTX, SMD = 0.11; 95%CI: 0.01, 0.21) in patients with T2DM, decreased serum alkaline phosphatase levels (ALP, SMD = -0.06; 95%CI: -0.10, -0.03), and had no significant effect on bone mineral density (BMD), procollagen type 1 N-terminal propeptide (P1NP), 25-hydroxy vitamin D, tartrate resistant acid phosphatase-5b (TRACP-5b) and osteocalcin. Conclusions SGLT2 inhibitors may negatively affect bone metabolism by increasing serum PTH, CTX, and decreasing serum ALP. This conclusion needs to be verified by more studies due to the limited number and quality of included studies. Systematic review registration PROSPERO, identifier CRD42023410701

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Section: Discussionmentioning

confidence: 99%

Effects of sodium-glucose cotransporter 2 inhibitors on bone metabolism in patients with type 2 diabetes mellitus: a systematic review and meta-analysis

Wang,

Li,

et al. 2024

BMC Endocr Disord

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“…FGF-23 and α-klotho may play important roles in the link between hyperphosphatemia and anemia [ 14 , 32 ]. High serum P can increase FGF-23 levels, which in turn suppresses the activity of α-klotho and aggravates vitamin D deficiency [ 32 , 33 ]. Klotho deficiency increases P reabsorption in the kidneys, which results in hyperphosphatemia [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Relationships between blood bone metabolic biomarkers and anemia in patients with chronic kidney disease

Fan

Yang

et al. 2023

Renal Failure

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Introduction Blood bone metabolic biomarkers are noninvasive indices for evaluating metabolic bone diseases. We investigated the relationships between blood bone metabolic biomarkers and anemia in chronic kidney disease (CKD) patients and analyzed the effects of parathyroidectomy (PTX) on the above indices. Methods In this cross-sectional study, 100 healthy controls and 239 CKD patients, including 46 secondary hyperparathyroidism (SHPT) patients with PTX, were enrolled. Moreover, a prospective study was conducted in which 28 PTX patients were followed up. The degree of anemia was classified as mild, moderate, or severe based on the tertiles of hemoglobin (Hb) levels of the anemic CKD patients, with cutoff values of 83 g/L and 102 g/L. Bone metabolic biomarkers, including calcium (Ca), phosphorus (P), intact parathyroid hormone (iPTH), fibroblast growth factor 23 (FGF23), and α-klotho, were tested. Results The mean estimated glomerular filtration rate (eGFR) in CKD patients was 25.7 ± 36.0 ml/min/1.73 m 2 , and 84.10% of CKD patients had anemia. The baseline Hb levels in the mild, moderate, and severe anemia subgroups were 110.86 ± 5.99 g/L, 92.71 ± 5.96 g/L, and 67.38 ± 10.56 g/L, respectively. CKD patients had higher adjusted Ca, P, alkaline phosphatase (ALP), iPTH, and FGF23 levels and lower α-klotho levels than controls. Baseline adjusted Ca, P, iPTH, and α-klotho levels were associated with Hb levels in CKD patients. Blood adjusted Ca, P, and iPTH levels were correlated with anemia severity. After PTX (median interval: 6.88 months), anemia and high blood adjusted Ca, P, iPTH, and FGF23 levels were ameliorated, while α-klotho levels were increased. Conclusions Blood adjusted Ca, P, iPTH, and α-klotho levels were correlated with Hb levels in CKD patients. Correction of bone metabolic disorders may be a therapeutic strategy for anemia treatment.

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“…FGF-23 and α-klotho may play important roles in the mechanism underlying the association between hyperphosphatemia and anemia [12,27] . High serum phosphorus can increase FGF-23 levels, which in turn suppresses the activity of α-klotho and aggravates vitamin D deficiency [27,28] . Klotho deficiency increases P reabsorption in the kidneys, which results in hyperphosphatemia [29] .…”

Section: Discussionmentioning

confidence: 99%

Relationship between blood bone metabolic biomarkers and anemia in CKD patients

Fan

Yang

et al. 2022

Preprint

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Introduction: Blood bone metabolic biomarkers are non-invasive indexes for evaluating renal osteodystrophy (ROD). Here the relationships between blood bone metabolic biomarkers and anemia in chronic kidney disease (CKD) patients are investigated, the effects of parathyroidectomy (PTX) on above indices are analyzed. Methods: In this cross-sectional study, 100 healthy controls and 239 CKD patients, including 46 secondary hyperparathyroidism (SHPT) subgroup with PTX, were enrolled. A prospective study with 28 PTX patients was followed up. The degree of anemia was classified as mild, moderate, and severe based on the tertiles of hemoglobin (Hb) levels of the anemic CKD patients, with cutoff values of 83g/L and 102g/L. Bone metabolic biomarkers, including calcium (Ca), phosphorus (P), intact parathyroid hormone (iPTH), fibroblast growth factor 23 (FGF23) and a-klotho were tested. Results: The mean eGFR in CKD patients was 25.74+-35.99 ml/min/1.73 m2 and 84.10% patients had anemia. The baseline Hb levels in the mild, moderate, and severe anemia subgroups were 110.86+-5.99g/L, 92.71+-5.96g/L and 67.38+-10.56g/L, respectively. CKD patients had higher adjusted Ca, P, ALP, iPTH and FGF23 levels, and lower a-klotho levels than controls. Baseline adjusted Ca, P, iPTH and a-klotho levels were associated with Hb in CKD patients. Blood adjusted Ca, P, iPTH levels were correlated with anemia severity. After PTX (median interval: 6.88 months), anemia and high blood adjusted Ca, P, iPTH and FGF23 levels were ameliorated, while a-klotho levels increased. Conclusions: Blood adjusted Ca, P, iPTH and a-klotho levels were correlated with Hb in CKD patients, correcting ROD is supposed to be therapeutic targets for anemia. Keywords: Anemia; Chronic kidney disease-mineral and bone disorder; Bone metabolic biomarkers; Parathyroidectomy; Secondary hyperparathyroidism

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Interactions between FGF23 and vitamin D

Cited by 14 publications

References 72 publications

Effects of sodium-glucose cotransporter 2 inhibitors on bone metabolism in patients with type 2 diabetes mellitus: a systematic review and meta-analysis

Effects of sodium-glucose cotransporter 2 inhibitors on bone metabolism in patients with type 2 diabetes mellitus: a systematic review and meta-analysis

Relationships between blood bone metabolic biomarkers and anemia in patients with chronic kidney disease

Relationship between blood bone metabolic biomarkers and anemia in CKD patients

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