Associations of serum vitamin D and fibroblast growth factor-23 with periodontitis severity: A cross-sectional study

Periodontitis is a chronic inflammatory disease associated with alveolar bone loss and alterations in mineral metabolism. Although 25-hydroxyvitamin D (25(OH)D) has been extensively investigated in the context of periodontal disease, data regarding fibroblast growth factor-23(FGF-23) remain limited, particularly across the different clinical stages of periodontitis.

A total of 100 systemically healthy individuals (20 controls; 80 periodontitis patients classified as Stage I-IV) were included. Periodontal examinations were performed, and serum 25(OH)D and FGF-23 levels were measured using ELISA. Group comparisons, correlation analyses, ROC curve analysis, and multivariate logistic regression adjusted for age, sex, and body mass index were conducted.

Serum 25(OH)D levels decreased, whereas FGF-23 levels increased with advancing periodontitis severity. (p = 0.01). 25(OH)D showed moderate negative, whereas FGF-23 showed moderate positive correlations with clinical periodontal parameters (p < 0.05). Both biomarkers showed moderate differentiation performance between advanced (Stage III-IV) and early disease stages (Stage I-II) (FGF-23: AUC = 0.714; 25(OH)D: AUC = 0.706). Bootstrap-adjusted multivariable linear regression analyses demonstrated that advanced periodontitis stage was independently associated with higher serum FGF-23 levels (B = 72.179, p = 0.006) and lower serum 25(OH)D levels (B = -6.818, p = 0.018). Furthermore, multivariate logistic regression analysis showed that FGF-23 (OR = 1.016; p = 0.003) and 25(OH)D (OR = 0.865; p = 0.022) remained independently associated with advanced periodontitis CONCLUSIONS: The observed increase in serum FGF-23 and the concomitant decrease in 25(OH)D levels across periodontitis stages may be associated with alterations in bone-mineral metabolism accompanying periodontal tissue destruction.