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Estrogens and bone disease in chronic kidney disease: role of FGF23

Jorge B Cannata-Andía1, Natalia Carrillo-López, Manuel Naves-Díaz

  • 1Bone and Mineral Research Unit, Hospital Universitario Central de Asturias, Instituto Reina Sofía de Investigación, REDinREN del ISCIII, Universidad de Oviedo, Oviedo, Asturias, Spain. metoseo@hca.es

Current Opinion in Nephrology and Hypertension
|June 24, 2010
PubMed
Abstract

Insights

Estrogen impacts bone directly by affecting bone cells and indirectly by influencing the calcium-phosphorus-vitamin D-parathyroid hormone (PTH) axis. Recent findings suggest Fibroblast Growth Factor 23 (FGF23) plays a role in estrogen-mediated PTH suppression.

Area of Science:

  • Endocrinology
  • Bone Biology
  • Mineral Metabolism

Background:

  • Estrogen exerts significant influence on bone health through both direct and indirect mechanisms.
  • Understanding the interplay between estrogen, bone cells, and mineral metabolism is crucial for bone health management.

Purpose of the Study:

  • To elucidate the direct and indirect effects of estrogen on bone.
  • To analyze recent findings on the role of Fibroblast Growth Factor 23 (FGF23) in estrogen-dependent parathyroid hormone (PTH) suppression.

Main Methods:

  • Review of existing literature on estrogen's effects on bone cells (osteoblasts and osteoclasts).
  • Analysis of in-vivo and in-vitro studies investigating the calcium-phosphorus-vitamin D-PTH axis.
  • Examination of the correlation between estrogen dosage, FGF23 levels, and changes in calcitriol and phosphorus.

Main Results:

  • Estrogens directly modulate bone cells, inhibiting osteoclast precursors and promoting osteoblast activity.
  • Estrogens indirectly influence bone by regulating the calcium-phosphorus-vitamin D-PTH axis.
  • Estrogen administration suppressed PTH secretion and reduced serum calcitriol and phosphorus levels, with FGF23 showing a dose-dependent positive correlation.

Conclusions:

  • Recent findings highlight the significance of indirect estrogen effects on bone.
  • FGF23 emerges as a potential mediator in the regulation of PTH by estrogens, impacting bone metabolism.

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