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Fibroblast Growth Factor 23, Mineral Metabolism, and Adiposity in Normal Kidney Function.

TitleFibroblast Growth Factor 23, Mineral Metabolism, and Adiposity in Normal Kidney Function.
Publication TypeJournal Article
Year of Publication2017
AuthorsZaheer, S, de Boer, IH, Allison, M, Brown, JM, Psaty, BM, Robinson-Cohen, C, Michos, ED, Ix, JH, Kestenbaum, B, Siscovick, D, Vaidya, A
JournalJ Clin Endocrinol Metab
Volume102
Issue4
Pagination1387-1395
Date Published2017 Apr 01
ISSN1945-7197
KeywordsAdiposity, Aged, Aged, 80 and over, Cross-Sectional Studies, Female, Fibroblast Growth Factors, Glomerular Filtration Rate, Humans, Kidney, Male, Middle Aged, Minerals, Renal Insufficiency, Chronic, Risk Factors
Abstract<p><b>Context: </b>Obesity is associated with poor bone mineralization and quality. Fibroblast growth factor 23 (FGF23) plays an important role in skeletal physiology.</p><p><b>Objective: </b>To test hypothesis that greater adiposity results in higher FGF23 levels among individuals with normal estimated glomerular filtration rate (eGFR).</p><p><b>Design, Setting, Participants: </b>Cross-sectional analyses among participants with eGFR ≥60 mL/min/1.73m2. We assessed the association between crude [body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR); n = 5610] and refined (abdominal adipose tissue area by computed tomography; n = 1313) measures of adiposity and FGF23 using multivariable linear regression.</p><p><b>Main Outcome Measure: </b>Serum FGF23.</p><p><b>Results: </b>FGF23 was higher across BMI categories (BMI <25: 37.7; BMI 25 to 29.99: 38.7; BMI 30 to 39.99: 39.8; BMI ≥40: 40.9 pg/mL, unadjusted P trend < 0.0001). The association between BMI and FGF23 was independent of known confounders of FGF23 (adjusted β = +7.2% higher FGF23 per 10 kg/m2; P < 0.0001). Similar results were observed using WC and WHR. Abdominal adipose tissue area was also independently associated with higher FGF23 (P < 0.01). Notably, the positive associations between FGF23 and adiposity were observed despite the fact that eGFR did not decline and serum phosphate levels did not increase with adiposity.</p><p><b>Conclusion: </b>In a large cohort with normal kidney function, adiposity was associated with higher FGF23 levels independent of known confounders, including eGFR and phosphate. Further studies are needed to evaluate the causes of higher FGF23 in settings of greater adiposity and the potential impact on skeletal health.</p>
DOI10.1210/jc.2016-3563
Alternate JournalJ. Clin. Endocrinol. Metab.
PubMed ID28323987
PubMed Central IDPMC5460732
Grant ListR01 HL071739 / HL / NHLBI NIH HHS / United States
2015085 / / Doris Duke Charitable Foundation / United States
R01 DK107407 / DK / NIDDK NIH HHS / United States
R01 HL072403 / HL / NHLBI NIH HHS / United States
N01 HC095166 / HC / NHLBI NIH HHS / United States
T32 HL007609 / HL / NHLBI NIH HHS / United States
N01 HC095169 / HC / NHLBI NIH HHS / United States
K23 HL111771 / HL / NHLBI NIH HHS / United States
R01 HL096875 / HL / NHLBI NIH HHS / United States
N01 HC095159 / HC / NHLBI NIH HHS / United States
F32 HL132477 / HL / NHLBI NIH HHS / United States
ePub date: 
17/04