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Serum Fibroblast Growth Factor-23 (FGF-23) and Fracture Risk in Elderly Men

Mirza, Majd Ai; Karlsson, Magnus LU ; Mellstrom, Dan; Orwoll, Eric; Ohlsson, Claes; Ljunggren, Osten and Larsson, Tobias E. (2011) In Journal of Bone and Mineral Research 26(4). p.857-864
Abstract
A normal mineral metabolism is integral for skeletal development and preservation of bone integrity. Fibroblast growth factor 23 (FGF-23) is a bone-derived circulating factor that decreases serum concentrations of inorganic phosphorous (P-i) and 1,25-dihydroxyvitamin D-3 [1,25(OH)(2)D-3]. Increased FGF-23 expression is a direct or indirect culprit in several skeletal disorders; however, the relation between FGF-23 and fracture risk remains undetermined. We evaluated the prospective relation between serum intact FGF-23 (measured by a two-site monoclonal antibody ELISA) and fracture risk employing the Swedish part of the population-based Osteoporotic Fractures in Men Study (MrOS; n = 2868; mean age 75.4 +/- 3.2 years; median follow-up period... (More)
A normal mineral metabolism is integral for skeletal development and preservation of bone integrity. Fibroblast growth factor 23 (FGF-23) is a bone-derived circulating factor that decreases serum concentrations of inorganic phosphorous (P-i) and 1,25-dihydroxyvitamin D-3 [1,25(OH)(2)D-3]. Increased FGF-23 expression is a direct or indirect culprit in several skeletal disorders; however, the relation between FGF-23 and fracture risk remains undetermined. We evaluated the prospective relation between serum intact FGF-23 (measured by a two-site monoclonal antibody ELISA) and fracture risk employing the Swedish part of the population-based Osteoporotic Fractures in Men Study (MrOS; n = 2868; mean age 75.4 +/- 3.2 years; median follow-up period 3.35 years). The incidence of at least one validated fracture after baseline was 20.4 per 1000 person-years. FGF-23 was directly related to the overall fracture risk [age-adjusted hazard ratio (HR) per SD increase = 1.20, 95% confidence interval (CI) 1.03-1.40] and vertebral fracture risk (HR = 1.33, 95% CI 1.02-1.75). Spline models revealed a nonlinear relation between FGF-23 and fracture risk, with the strongest relation at FGF-23 levels above 55.7 pg/mL. FGF-23 levels above 55.7 pg/mL also were associated with an increased risk for hip and nonvertebral fractures (HR = 2.30, 95% CI 1.16-4.58, and HR = 1.63, 95% CI 1.01-2.63, respectively). These relations remained essentially unaltered after adjustment for bodymass index (BMI), bone mineral density (BMD), glomerular filtration rate, 25(OH)(2)D-3, parathyroid hormone (PTH), and other fracture risk factors. In conclusion, FGF-23 is a novel predictor of fracture risk in elderly men. (C) 2011 American Society for Bone and Mineral Research. (Less)
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author
organization
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type
Contribution to journal
publication status
published
subject
keywords
FGF-23, FRACTURES, BONE MINERAL DENSITY, BMD, VITAMIN D, CALCITRIOL, RICKETS, OSTEOMALACIA
in
Journal of Bone and Mineral Research
volume
26
issue
4
pages
857 - 864
publisher
AMBMR
external identifiers
  • wos:000288861400020
  • scopus:79953046736
ISSN
1523-4681
DOI
10.1002/jbmr.263
language
English
LU publication?
yes
id
291fdd38-7335-405a-a9c3-9d358699f869 (old id 1925284)
date added to LUP
2011-05-02 09:54:18
date last changed
2017-09-10 03:21:28
@article{291fdd38-7335-405a-a9c3-9d358699f869,
  abstract     = {A normal mineral metabolism is integral for skeletal development and preservation of bone integrity. Fibroblast growth factor 23 (FGF-23) is a bone-derived circulating factor that decreases serum concentrations of inorganic phosphorous (P-i) and 1,25-dihydroxyvitamin D-3 [1,25(OH)(2)D-3]. Increased FGF-23 expression is a direct or indirect culprit in several skeletal disorders; however, the relation between FGF-23 and fracture risk remains undetermined. We evaluated the prospective relation between serum intact FGF-23 (measured by a two-site monoclonal antibody ELISA) and fracture risk employing the Swedish part of the population-based Osteoporotic Fractures in Men Study (MrOS; n = 2868; mean age 75.4 +/- 3.2 years; median follow-up period 3.35 years). The incidence of at least one validated fracture after baseline was 20.4 per 1000 person-years. FGF-23 was directly related to the overall fracture risk [age-adjusted hazard ratio (HR) per SD increase = 1.20, 95% confidence interval (CI) 1.03-1.40] and vertebral fracture risk (HR = 1.33, 95% CI 1.02-1.75). Spline models revealed a nonlinear relation between FGF-23 and fracture risk, with the strongest relation at FGF-23 levels above 55.7 pg/mL. FGF-23 levels above 55.7 pg/mL also were associated with an increased risk for hip and nonvertebral fractures (HR = 2.30, 95% CI 1.16-4.58, and HR = 1.63, 95% CI 1.01-2.63, respectively). These relations remained essentially unaltered after adjustment for bodymass index (BMI), bone mineral density (BMD), glomerular filtration rate, 25(OH)(2)D-3, parathyroid hormone (PTH), and other fracture risk factors. In conclusion, FGF-23 is a novel predictor of fracture risk in elderly men. (C) 2011 American Society for Bone and Mineral Research.},
  author       = {Mirza, Majd Ai and Karlsson, Magnus and Mellstrom, Dan and Orwoll, Eric and Ohlsson, Claes and Ljunggren, Osten and Larsson, Tobias E.},
  issn         = {1523-4681},
  keyword      = {FGF-23,FRACTURES,BONE MINERAL DENSITY,BMD,VITAMIN D,CALCITRIOL,RICKETS,OSTEOMALACIA},
  language     = {eng},
  number       = {4},
  pages        = {857--864},
  publisher    = {AMBMR},
  series       = {Journal of Bone and Mineral Research},
  title        = {Serum Fibroblast Growth Factor-23 (FGF-23) and Fracture Risk in Elderly Men},
  url          = {http://dx.doi.org/10.1002/jbmr.263},
  volume       = {26},
  year         = {2011},
}