Serum Fibroblast Growth Factor-23 (FGF-23) and Fracture Risk in Elderly Men
Serum Fibroblast Growth Factor-23 (FGF-23) and Fracture Risk in Elderly Men
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DOI：
10.1002/jbmr.263
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发表时间：
2011-04-01
影响因子：
6.2
通讯作者：
Larsson, Tobias E.
中科院分区：
文献类型：
--
作者：
Mirza, Majd Ai;Karlsson, Magnus K.;Larsson, Tobias E.
正常的矿物质代谢对于骨骼发育和保持骨骼完整性是不可或缺的。成纤维细胞生长因子23（FGF-23）是一种骨源性循环因子，可降低血清中无机磷（P（i））和1，25-二羟维生素D（3）[1，25（OH）（2）D（3）]的浓度。FGF-23表达增加是几种骨骼疾病的直接或间接罪魁祸首;然而，FGF-23与骨折风险之间的关系仍未确定。我们采用男性骨质疏松性骨折研究的瑞典部分（MrOS; n = 2868;平均年龄75.4 ± 3.2岁;中位随访期3.35年）评估了血清完整FGF-23（通过双位点单克隆抗体ELISA测定）与骨折风险之间的前瞻性关系。基线后至少1例经验证骨折的发生率为20.4/1000人-年。FGF-23与总体骨折风险[年龄调整风险比（HR）/SD增加= 1.20，95%置信区间（CI）1.03-1.40]和椎骨骨折风险（HR = 1.33，95% CI 1.02-1.75）直接相关。样条模型揭示了FGF-23与骨折风险之间的非线性关系，FGF-23水平高于55.7 pg/mL时关系最强。FGF-23水平高于55.7 pg/mL也与髋部和非椎骨骨折风险增加相关（HR = 2.30，95% CI 1.16-4.58和HR = 1.63，95% CI 1.01-2.63）。在调整了体重指数（BMI）、骨密度（BMD）、肾小球滤过率、25（OH）（2）D（3）、甲状旁腺激素（PTH）和其他骨折危险因素后，这些关系基本上保持不变。总之，FGF-23是老年男性骨折风险的新预测因子。(C)2011年美国骨与矿物质研究学会。
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.