Fibroblast growth factor 23 concentrations and modifying factors in children from age 12 to 24 months
Maria Enlund-Cerullo1, Helena Hauta-Alus2, Saara Valkama2
1Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland; Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Finland.
Insights
Fibroblast growth factor 23 (FGF23) levels decrease in children from 12 to 24 months. Iron influences FGF23 concentrations in both boys and girls, while vitamin D supplementation did not alter FGF23 levels.
Area of Science:
- Pediatric Endocrinology
- Mineral Metabolism
- Growth Factor Research
Background:
- Fibroblast growth factor 23 (FGF23) is crucial for phosphate, calcium, and vitamin D regulation.
- Factors influencing FGF23 in children are not well understood.
Purpose of the Study:
- To investigate temporal changes in FGF23 concentrations between 12 and 24 months in healthy children.
- To identify factors that modify FGF23 levels, including vitamin D intervention, iron status, and seasonality.
Main Methods:
- A randomized controlled trial (VIDI) involving 594 infants receiving 10 or 30 μg/day of vitamin D3.
- Analysis of intact (iFGF23) and C-terminal (cFGF23) FGF23, 25-hydroxyvitamin D, and iron markers at 12 and 24 months.
- Linear mixed models were used to assess changes and modifying factors.
Main Results:
- FGF23 levels (both iFGF23 and cFGF23) significantly decreased from 12 to 24 months in both boys and girls.
- Girls exhibited higher iFGF23 levels than boys at both time points.
- Iron status was identified as a significant modifier of FGF23 in both sexes.
Conclusions:
- FGF23 concentrations naturally decline between 12 and 24 months of age.
- Iron status is a key factor influencing FGF23 levels in young children.
- Vitamin D intervention dose did not impact FGF23 levels in this cohort.
Background And Objectives:
Fibroblast growth factor 23 (FGF23) participates in phosphate, calcium and vitamin D metabolism. In children these interactions and modifying factors are largely unknown.
Participants And Methods:
This study evaluates temporal changes and modifiers of FGF23 concentrations from 12 to 24 months, in healthy children, participating in a randomized vitamin D intervention (VIDI). Participants received vitamin D3 of 10 or 30 μg/day from age 2 weeks to 24 months. At 12 and 24 months, growth measurements and venous blood samples were obtained for analyses of intact (iFGF23) and C-terminal FGF23 (cFGF23), 25-hydroxyvitamin D (25-OHD), calcium, phosphate, parathyroid hormone, iron and ferritin. Changes in FGF23 and modifying factors were examined by linear mixed models.
Results:
The study included 594 infants. Girls had higher iFGF23 than boys (p < 0.001 for both 12 and 24 months), cFGF23 did not differ between the sexes. Adjusted mean iFGF23 decreased from 41.4 to 38.1 pg/mL in boys (p < 0.001) and from 45.2 to 42.5 pg/mL in girls (p = 0.002). Adjusted mean cFGF23 decreased from 2.89 to 2.00 pmol/L in boys (p < 0.001) and from 2.92 to 1.93 pmol/L in girls (p < 0.001). Iron modified FGF23 in both sexes, associating positively with iFGF23 and inversely with cFGF23. In girls, 25-OHD modified iFGF23. In boys, season modified FGF23, possibly through seasonal differences in 25-OHD. Vitamin D intervention dose did not affect FGF23.
Conclusions:
FGF23 decreases from 12 to 24 months. Girls have higher iFGF23 than boys, at both time points. Iron modifies FGF23 in both sexes.
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