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FGF-23 is elevated by chronic hyperphosphatemia.

A Gupta1, K Winer, M J Econs

  • 1National Institutes of Health, 30 Convent Drive, Building 30, Room 228, MSC 4320, Bethesda, Maryland 20892-4320, USA.

The Journal of Clinical Endocrinology and Metabolism
|September 10, 2004
PubMed
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Fibroblast growth factor 23 (FGF-23) serum levels increase with hyperphosphatemia in hypoparathyroidism. This suggests FGF-23 regulates phosphorus, but is insufficient to normalize levels in this condition.

Area of Science:

  • Endocrinology
  • Nephrology
  • Mineral Metabolism

Background:

  • Fibroblast growth factor 23 (FGF-23) is a hormone regulating phosphorus and calcium metabolism.
  • Circulating FGF-23 promotes renal phosphorus excretion and is measurable in serum.
  • Serum FGF-23 levels are elevated in phosphate-wasting disorders, but factors influencing its concentration are unclear.

Purpose of the Study:

  • To investigate the relationship between serum FGF-23, phosphorus, and parathyroid hormone (PTH) levels.
  • To circumvent confounding effects of PTH and calcium by studying patients with hypoparathyroidism and hyperphosphatemia.

Main Methods:

  • Serum samples were collected after an overnight fast from three groups: hypoparathyroid patients (n=9), hyperparathyroid patients (n=9), and normal controls (n=77).

Related Experiment Videos

  • Serum phosphorus and FGF-23 levels were measured in all participants.
  • Statistical analysis was performed to compare FGF-23 and phosphorus levels between groups.

    • Main Results:

    • Patients with hypoparathyroidism exhibited significantly higher serum phosphorus levels compared to hyperparathyroid patients and normal controls (p < 0.01).
    • Serum FGF-23 levels were significantly elevated in hypoparathyroid patients compared to both hyperparathyroid patients and normal controls (p < 0.05).

    Conclusions:

    • Serum FGF-23 levels are elevated in patients with hyperphosphatemia and chronic hypoparathyroidism.
    • This suggests a feedback system where FGF-23 responds to and regulates serum phosphorus levels.
    • However, FGF-23 elevation is insufficient to normalize phosphorus in hypoparathyroidism.