Clinical usefulness of measurement of fibroblast growth factor 23 (FGF23) in hypophosphatemic patients - Proposal of diagnostic criteria using FGF23 measurement
Clinical usefulness of measurement of fibroblast growth factor 23 (FGF23) in hypophosphatemic patients - Proposal of diagnostic criteria using FGF23 measurement
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DOI：
10.1016/j.bone.2008.02.014
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发表时间：
2008-06-01
期刊：
影响因子：
4.1
通讯作者：
Matsumoto, Toshio
中科院分区：
文献类型：
--
作者：
Endo, Itsuro;Fukumoto, Seiji;Matsumoto, Toshio
成纤维细胞生长因子23（FGF 23）在低磷血症性疾病如肿瘤诱导的骨软化症（TIO）和X连锁低磷血症性佝偻病/骨软化症（XLH）的发展中起重要作用。然而，测量FGF 23的临床用途尚未确定。本研究的目的是检查FGF 23测量在低磷血症疾病诊断中的重要性。在横断面研究中分析了有关磷酸盐代谢的生化参数。32例TIO、28例XLH和16例其他原因引起的低磷血症患者，包括维生素D缺乏、范可尼综合征和库欣综合征。在TIO和XLH患者中，大多数患者的FGF 23高于参考范围的上限，无论是否接受药物治疗。FGF 23在这些患者中最低为38.0pg/ml。其他原因引起的低磷血症患者中，12例患者的FGF 23检测不到（小于3 pg/ml），该组中的最高FGF 23为23.9 pg/ml。磷酸盐和FGF 23之间的关系表明，TIO和XLH是根据血清磷酸盐的年龄依赖性参考范围判断的具有高FGF 23和低磷酸盐血症的疾病。FGF 23测量可用于鉴别诊断由FGF 23的过度作用和其他病因引起的低磷酸盐血症疾病。通过磷酸盐的年龄依赖性参考范围判断的高FGF 23和低磷酸盐建立了由FGF 23的过度作用引起的疾病的诊断。(C)2008年爱思唯尔公司All rights reserved.
Fibroblast growth factor 23 (FGF23) plays important roles in the development of hypophosphatemic diseases such as tumor-induced osteomalacia (TIO) and X-linked hypophosphatemic rickets/osteomalacia (XLH). However, clinical usefulness of measurement of FGF23 has not been established. The objective of this study is to examine the importance of FGF23 measurement in the diagnosis of hypophosphatemic diseases. Biochemical parameters concerning phosphate metabolism were analyzed in a cross-sectional study. 32 patients with TIO, 28 patients with XLH and 16 hypophosphatemic patients with other causes including vitamin D deficiency, Fanconi's syndrome and Cushing's syndrome were studied. In patients with TIO and XLH, FGF23 was above the upper limit of the reference range in most patients irrespective of medical treatment. The lowest FGF23 in these patients was 38.0 pg/ml. FGF23 in hypophosphatemic patients with other causes was undetectable (less than 3 pg/ml) in 12 patients and the highest FGF23 in this group was 23.9 pg/ml. Relationship between phosphate and FGF23 indicated that TIO and XLH are diseases with high FGF23 and hypophosphatemia judged by age-dependent reference ranges for serum phosphate. FGF23 measurement is useful for differential diagnosis of hypophosphatemic diseases caused by excess actions of FGF23 and other etiologies. High FGF23 with low phosphate judged by age-dependent reference ranges for phosphate establishes the diagnosis of diseases caused by excess actions of FGF23. (C) 2008 Elsevier Inc. All rights reserved.