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Serum fibroblast growth factor-23 (FGF-23) and fracture risk in elderly men.

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.

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  • Authors+Show Affiliations

    ,

    Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden. majd.mirza@medsci.uu.se

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    Source

    MeSH

    Age Factors
    Aged
    Aged, 80 and over
    Bone Density
    Fibroblast Growth Factors
    Fractures, Bone
    Glomerular Filtration Rate
    Hip Fractures
    Humans
    Kaplan-Meier Estimate
    Male
    Osteoporosis
    Proportional Hazards Models
    Prospective Studies
    Risk Factors
    Spinal Fractures
    Sweden

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    20928885

    Citation

    Mirza, Majd Ai, et al. "Serum Fibroblast Growth Factor-23 (FGF-23) and Fracture Risk in Elderly Men." Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, vol. 26, no. 4, 2011, pp. 857-64.
    Mirza MA, Karlsson MK, Mellström D, et al. Serum fibroblast growth factor-23 (FGF-23) and fracture risk in elderly men. J Bone Miner Res. 2011;26(4):857-64.
    Mirza, M. A., Karlsson, M. K., Mellström, D., Orwoll, E., Ohlsson, C., Ljunggren, O., & Larsson, T. E. (2011). Serum fibroblast growth factor-23 (FGF-23) and fracture risk in elderly men. Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 26(4), pp. 857-64. doi:10.1002/jbmr.263.
    Mirza MA, et al. Serum Fibroblast Growth Factor-23 (FGF-23) and Fracture Risk in Elderly Men. J Bone Miner Res. 2011;26(4):857-64. PubMed PMID: 20928885.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Serum fibroblast growth factor-23 (FGF-23) and fracture risk in elderly men. AU - Mirza,Majd Ai, AU - Karlsson,Magnus K, AU - Mellström,Dan, AU - Orwoll,Eric, AU - Ohlsson,Claes, AU - Ljunggren,Osten, AU - Larsson,Tobias E, PY - 2010/10/8/entrez PY - 2010/10/12/pubmed PY - 2011/9/3/medline SP - 857 EP - 64 JF - Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research JO - J. Bone Miner. Res. VL - 26 IS - 4 N2 - 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. SN - 1523-4681 UR - https://www.unboundmedicine.com/medline/citation/20928885/Serum_fibroblast_growth_factor_23__FGF_23__and_fracture_risk_in_elderly_men_ L2 - https://doi.org/10.1002/jbmr.263 DB - PRIME DP - Unbound Medicine ER -