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Published on: January 19, 2024
Iron status and fibroblast growth factor-23 in Gambian children
Vickie Braithwaite1, Landing M A Jarjou, Gail R Goldberg
1Medical Research Council (MRC) Human Nutrition Research, Cambridge, UK. Vickie.braithwaite@mrc-hnr.cam.ac.uk
Insights
Iron deficiency anemia is common in The Gambia. This study found a stronger link between fibroblast growth factor-23 (FGF23) and hemoglobin in Gambian children with rickets, suggesting iron
Area of Science:
- Pediatric Endocrinology
- Nutritional Biochemistry
- Bone Metabolism
Background:
- Iron deficiency anemia is prevalent in The Gambia.
- Elevated fibroblast growth factor-23 (FGF23) is observed in Gambian children with rickets-like bone deformities.
- Low iron status is hypothesized to contribute to the etiology of Gambian rickets.
Purpose of the Study:
- To investigate the relationship between hemoglobin, as a marker of iron status, and FGF23.
- To determine if this relationship differs between children with and without a history of rickets-like bone deformities in The Gambia.
Main Methods:
- Retrospective analysis of data from 2006-2008 in a rural Gambian community.
- Age-adjusted linear regression modeling was used to analyze FGF23 and hemoglobin concentrations.
- Data included children with rickets-like bone deformity (n=108) and local community children (n=382).
Main Results:
- Circulating FGF23 concentration was inversely correlated with hemoglobin concentration.
- This inverse correlation was more pronounced in children with bone deformities compared to the local community.
- Anemia and elevated FGF23 were significantly more prevalent in children with bone deformities.
Conclusions:
- A stronger relationship exists between FGF23 and hemoglobin in Gambian children with a history of rickets.
- These findings support the hypothesis that iron plays a role in FGF23 metabolic pathways.
- Iron status may be implicated in the pathogenesis of rickets in Gambian children.
Abstract:
A relationship between iron and fibroblast growth factor-23 (FGF23) metabolic pathways has been proposed. Iron deficiency anaemia is prevalent in The Gambia and concentrations of fibroblast growth factor-23 FGF23 are elevated in a large percentage of Gambian children with rickets-like bone deformity. We speculate that low iron status may be involved in the aetiology of Gambian rickets. The aim of this study was to determine if there was a relationship between haemoglobin, as a marker of iron status, and FGF23 in samples from children with and without a history of rickets-like bone deformities in The Gambia. We conducted a retrospective analysis of studies carried out from 2006 to 2008 in children from a rural community in The Gambia where iron deficiency anaemia is endemic and where elevated circulating concentrations of FGF23 have been found. To investigate the relationship between circulating FGF23 and haemoglobin concentrations we used an age-adjusted linear regression model on data from children <18y of age with a family or personal history of rickets-like bone deformity (BD) (n=108) and from the local community (LC) (n=382). We found that circulating concentration of FGF23 was inversely correlated with haemoglobin concentration. This effect was more pronounced in BD children compared with LC children (interaction: P≤0.0001). Anaemia and elevated FGF23 were more prevalent in BD children compared to LC children (P=0.0003 and P=0.0001 respectively). In conclusion, there is a stronger relationship between FGF23 and haemoglobin in Gambian children with a history of rickets compared to local community children. This study provides support for the contention that iron may be involved in FGF23 metabolic pathways.