Related Experiment Video
Updated: Feb 4, 2026

Reverse Dissection and DiceCT Reveal Otherwise Hidden Data in the Evolution of the Primate Face
Published on: January 7, 2019
Elevated FGF23 Despite Biochemical Control Reveals Hidden Mineral Dysregulation in Chronic Hypoparathyroidism
Matteo Malagrinò1,2, Anna Piazza1,2, Nicolò Bisceglia1,2
1Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna 40138, Italy.
Background:
Fibroblast growth factor (FGF23) is a phosphate-regulating hormone and might be a biomarker of cardiorenal comorbidities in the general population. Its role in hypoparathyroidism is unclear.
Objective:
To assess the prevalence of abnormal FGF23 concentrations in patients with chronic hypoparathyroidism and explore their associations with mineral metabolism and renal phosphate handling.
Design:
Cross-sectional, observational study complemented by a retrospective longitudinal analysis of biochemical parameters over a median follow-up of 5 years.
Patients:
Forty-eight consecutive patients with chronic hypoparathyroidism (mean age 60.6 ± 16.3 years; 85% women; 87.5% postsurgical) evaluated at an academic medical center between January 2023 and December 2024.
Measurements:
Serum intact FGF23 levels, serum calcium (Ca) and phosphate (P), Ca × P product, PTH, 1,25-dihydroxyvitamin D [1,25(OH)2D], estimated glomerular filtration rate (eGFR), and renal phosphate reabsorption [maximum rate of renal tubular reabsorption of phosphate/glomerular filtration rate (TmPO4/GFR)].
Results:
Elevated FGF23 levels were found in 71% of patients (mean 157.9 ± 92.4 pg/mL; reference range 23.2-95.4), despite adequate biochemical control (calcium 8.7 ± 0.8 mg/dL; phosphate 4.5 ± 0.8 mg/dL; Ca × P product 39.2 ± 6.8 mg²/dL²). FGF23 was associated with longer disease duration (P = .004), lower eGFR (P = .008), lower PTH (P = .03), reduced 1,25(OH)2D (P = .016), and elevated Ca × P product (P = .036). Despite elevated FGF23, TmPO4/GFR was paradoxically increased, suggesting impaired renal responsiveness. Female sex and Ca × P product were independent predictors of FGF23 levels.
Conclusion:
FGF23 is frequently elevated in chronic hypoparathyroidism, indicating a disrupted phosphate metabolism, and its increase seems to be ineffective in promoting phosphate excretion, probably due to renal resistance mechanisms. Further studies are needed to clarify the role of FGF23 as a clinical biomarker, risk factor, and potential therapeutic target in this population.
More Related Videos
Related Concept Videos
Freezing Point Depression and Boiling Point Elevation
The boiling point of a liquid is the temperature at which its vapor pressure is equal to ambient atmospheric pressure. Since the vapor pressure of a solution is lowered due to the presence of nonvolatile solutes, it stands to reason that the solution’s boiling point will subsequently be increased. Vapor pressure increases with temperature, and so a solution will require a higher temperature than will pure solvent to achieve any given vapor pressure, including one...
Water and Mineral Acquisition
Minerals
Major...
Elevation of Intermediate Points on Vertical Curves
Essential Minerals for Bone Health
Calcium and Phosphorus
Calcium is a critical component of bones, especially in the form of calcium phosphate and calcium carbonate. Since the body cannot make calcium, it must be obtained from the diet. However, calcium cannot be absorbed from the small intestine without...
Mineral, Vitamin and Water Absorption

