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FGF23 is elevated in Gambian children with rickets.
Ann Prentice1, Mustapha Ceesay, Shailja Nigdikar
1MRC Keneba, The Gambia. ann.prentice@mrc-hnr.cam.ac.uk
Bone
|February 1, 2008
Summary
Elevated Fibroblast Growth Factor 23 (FGF23) and low phosphate levels suggest a role in African rickets. These findings highlight potential FGF23 and phosphate regulation issues in calcium-deficiency rickets.
Area of Science:
- Pediatric Endocrinology
- Mineral Metabolism
- Nutritional Rickets
Background:
- Fibroblast Growth Factor 23 (FGF23) is a key regulator of phosphate homeostasis.
- Rickets, particularly in the absence of vitamin D deficiency, is observed in populations with low calcium intake, but risk factors remain unclear.
- Previous studies have indicated elevated FGF23 in certain hypophosphatemic conditions.
Purpose of the Study:
- To investigate the biochemical profile, including FGF23 levels, in Gambian children with rickets of unknown etiology.
- To compare FGF23 concentrations in these patients with those of healthy local children.
- To explore potential associations between FGF23, phosphate, and rickets severity.
Main Methods:
- A cohort of 46 Gambian children with rickets and plasma 25-hydroxyvitamin D above 20 nmol/l were studied.
- Plasma FGF23, phosphate, alkaline phosphatase, and other biochemical markers were measured.
- Patient samples were compared to those from a control group of local children.
Main Results:
- Rickets patients exhibited lower plasma phosphate and 25-hydroxyvitamin D, and higher alkaline phosphatase compared to controls.
- Significantly elevated FGF23 concentrations were observed in rickets patients (mean 367 RU/ml) versus controls (mean 51 RU/ml).
- Plasma phosphate showed a significant inverse correlation with FGF23 levels.
Conclusions:
- The findings suggest that dysregulation of phosphate and FGF23 may contribute to the development of calcium-deficiency rickets in African and Asian populations.
- Elevated FGF23 levels, despite adequate vitamin D status, point towards alternative pathogenic mechanisms in certain forms of rickets.
- Further research into FGF23 and phosphate metabolism is warranted for understanding and managing rickets in these regions.
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