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Updated: May 5, 2026

Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Published on: June 16, 2014

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Fibroblast growth-factor 23-Klotho axis is associated with systemic inflammation and myokine profile in children with

Vasiliki Karava1, Antonia Kondou2, John Dotis2

  • 1Pediatric Nephrology Unit, 1st Department of Pediatrics, Hippokratio General Hospital, Aristotle University of Thessaloniki, 49 Konstantinoupoleos Street, Thessaloniki, 54642, Greece. vasilikikarava@hotmail.fr.

Hormones (Athens, Greece)
|August 7, 2024
PubMed

Insights

In pediatric chronic kidney disease (CKD), fibroblast growth factor-23 (FGF23) and myostatin/IGF-1 ratio link to inflammation. These findings suggest interactions between mineral bone and muscle metabolism in pediatric CKD.

Area of Science:

  • Pediatric Nephrology
  • Endocrinology
  • Metabolic Research

Background:

  • Chronic kidney disease (CKD) is associated with disruptions in the fibroblast growth factor-23 (FGF23)-Klotho axis.
  • An imbalance in myostatin and insulin-like growth factor-1 (IGF-1) expression is also observed in CKD.
  • These disturbances may contribute to systemic inflammation, particularly elevated interleukin-6 (IL-6) levels.

Purpose of the Study:

  • To investigate the association between the FGF23-Klotho axis and the myokine profile (myostatin, IGF-1, follistatin) in pediatric CKD patients.
  • To examine the relationship of these factors with serum IL-6 levels and their interactions.
  • To explore potential links between mineral bone metabolism and muscle health in pediatric CKD.

Main Methods:

  • Cross-sectional study of 53 pediatric patients with GFR < 60 ml/min/1.73m².
  • Measurement of serum calcium, phosphorus, 25-hydroxyvitamin D, parathormone, FGF23, Klotho, myostatin, follistatin, IGF-1, and IL-6.
  • Calculation of myostatin to lean mass (LM) and myostatin to IGF-1 ratios; high IL-6 defined as > 3rd quartile.

Main Results:

  • Myostatin, IGF-1, and follistatin levels correlated significantly with lean mass and with each other.
  • The myostatin/LM ratio was significantly higher in advanced CKD (CKD 5D) patients.
  • Elevated FGF23 and myostatin/IGF-1 ratio were associated with higher IL-6 levels, even after adjusting for CKD stage and other parameters.
  • Myostatin correlated with FGF23, and myostatin/IGF-1 ratio correlated with Klotho.

Conclusions:

  • In pediatric CKD, FGF23 and the myostatin/IGF-1 ratio are linked to elevated IL-6, suggesting a connection between systemic inflammation, mineral bone disorders, and myokine dysregulation.
  • The observed correlations between myostatin and FGF23, and between myostatin/IGF-1 ratio and Klotho, indicate a potential interaction between mineral bone and muscle metabolism in this population.
Abstract

Keywords:
FGF23FollistatinIGF-1IL-6KlothoMineral bone disordersMuscleMyostatin

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