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Fibroblast growth factor 23 and renal function among young and healthy individuals

  • Raffaele Bernasconi ORCID logo , Stefanie Aeschbacher , Steffen Blum , Michel Mongiat , Marc Girod , John Todd , Joel Estis , Niamh Nolan , Harald Renz , Lorenz Risch , David Conen and Martin Risch EMAIL logo
Published/Copyright: May 1, 2018
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 56 Issue 9

Abstract

Background:

Fibroblast growth factor 23 (FGF-23), an osteocyte hormone involved in the regulation of phosphate metabolism, is associated with incident and progressive chronic kidney disease. We aimed to assess the association of FGF-23 with renal parameters, vascular function and phosphate metabolism in a large cohort of young and healthy individuals.

Methods:

Healthy individuals aged 25–41 years were included in a prospective population-based study. Fasting venous blood and morning urinary samples were used to measure plasma creatinine, cystatin C, endothelin-1, phosphate and plasma FGF-23 as well as urinary creatinine and phosphate. Multivariable regression models were constructed to assess the relationship of FGF-23 with parameters of renal function, endothelin-1 and fractional phosphate excretion.

Results:

The median age of 2077 participants was 37 years, 46% were males. The mean estimated glomerular filtration rate (eGFR – CKD-EPI creatinine-cystatin C equation) and fractional phosphate excretion were 110 mL/min/1.73 m2 and 8.7%, respectively. After multivariable adjustment, there was a significant inverse relationship of FGF-23 with eGFR (β per 1 log-unit increase −3.81; 95% CI [−5.42; −2.20]; p<0.0001). Furthermore, we found a linear association between FGF-23 and endothelin-1 (β per 1 log-unit increase 0.06; [0.01, 0.11]; p=0.01). In addition, we established a significant relationship of FGF-23 with fractional phosphate excretion (β per 1 log-unit increase 0.62; [0.08, 1.16]; p=0.03).

Conclusions:

Increasing plasma FGF-23 levels are strongly associated with decreasing eGFR and increasing urinary phosphate excretion, suggesting an important role of FGF-23 in the regulation of kidney function in young and healthy adults.

Keywords: cystatin C; endothelin-1; fibroblast growth factor-23; glomerular filtration rate; phosphate excretion; renal function
Corresponding authors: Martin Risch, MD, Labormedizinisches Zentrum Dr. Risch, Vaduz, Principality of Liechtenstein

Acknowledgments

We thank the staff and participants of the GAPP study for their important contributions.

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: The Swiss National Science Foundation (Funder Id: 10.13039/501100001711), the Liechtenstein Government, the Swiss Heart Foundation (Funder Id: 10.13039/501100004362), the Swiss Society of Hypertension, the University of Basel (Funder Id: 10.13039/100008375), the University Hospital Basel, the Mach-Gaensslen Foundation, the Hanela Foundation, Schiller AG and Novartis (Funder Id: 10.13039/100004336) supported the GAPP study. Endothelin-1 was measured free of charge by Singulex, Inc., Alameda, CA 94502, USA. Reagents for FGF-23 measurements were provided at a reduced cost by Diasorin Switzerland AG, Rotkreuz, Switzerland.

  3. Employment or leadership: John Todd, Joel Estis and Niamh Nolan are employees of Singulex, Inc.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Supplementary Material:

The online version of this article offers supplementary material (https://doi.org/10.1515/cclm-2017-1183).

Received: 2017-12-19
Accepted: 2018-03-08
Published Online: 2018-05-01
Published in Print: 2018-08-28

©2018 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/cclm-2017-1183
Keywords for this article
cystatin C; endothelin-1; fibroblast growth factor-23; glomerular filtration rate; phosphate excretion; renal function

Articles in the same Issue

  1. Frontmatter
  2. Editorials
  3. Clinical Chemistry and Laboratory Medicine continues to shine brightly in the constellation of laboratory medicine
  4. The Theranos saga and the consequences
  5. Innovative approaches in diabetes diagnosis and monitoring: less invasive, less expensive… but less, equally or more efficient?
  6. Reviews
  7. Exploring the microbiota to better understand gastrointestinal cancers physiology
  8. Linking type 2 diabetes and gynecological cancer: an introductory overview
  9. Mini Reviews
  10. MicroRNAs as predictive biomarkers of response to tyrosine kinase inhibitor therapy in metastatic renal cell carcinoma
  11. Salivary biomarkers and cardiovascular disease: a systematic review
  12. Opinion Paper
  13. The meteoric rise and dramatic fall of Theranos: lessons learned for the diagnostic industry
  14. General Clinical Chemistry and Laboratory Medicine
  15. Uncertainty evaluation in clinical chemistry, immunoassay, hematology and coagulation analytes using only external quality assessment data
  16. Measurement uncertainty and metrological traceability of whole blood cyclosporin A mass concentration results obtained by UHPLC-MS/MS
  17. Computer-assisted interventions in the clinical laboratory process improve the diagnosis and treatment of severe vitamin B12 deficiency
  18. Trueness, precision and stability of the LIAISON 1-84 parathyroid hormone (PTH) third-generation assay: comparison to existing intact PTH assays
  19. Fibroblast growth factor 23 and renal function among young and healthy individuals
  20. Optimizing charge state distribution is a prerequisite for accurate protein biomarker quantification with LC-MS/MS, as illustrated by hepcidin measurement
  21. Quantification of human complement C2 protein using an automated turbidimetric immunoassay
  22. EE score: an index for simple differentiation of homozygous hemoglobin E and hemoglobin E-β0-thalassemia
  23. Reference Values and Biological Variations
  24. Algorithm on age partitioning for estimation of reference intervals using clinical laboratory database exemplified with plasma creatinine
  25. A simple transformation independent method for outlier definition
  26. Cancer Diagnostics
  27. Quantification of vanillylmandelic acid, homovanillic acid and 5-hydroxyindoleacetic acid in urine using a dilute-and-shoot and ultra-high pressure liquid chromatography tandem mass spectrometry method
  28. Cardiovascular Diseases
  29. Sialylated isoforms of apolipoprotein C-III and plasma lipids in subjects with coronary artery disease
  30. Diabetes
  31. Analysis of protein glycation in human fingernail clippings with near-infrared (NIR) spectroscopy as an alternative technique for the diagnosis of diabetes mellitus
  32. Letter to the Editor
  33. Preanalytical errors before and after implementation of an automatic blood tube labeling system in two outpatient phlebotomy centers
  34. Hemolysis interference studies: freeze method should be used in the preparation of hemolyzed samples
  35. The curious case of postprandial glucose less than fasting glucose: little things that matter much
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