Fibroblast growth factor 23 and its role in phosphate homeostasis in growing children compared to adults

Marjan Jeddi; Maryam Heidari; Neda Hatami; Gholam Hossein Ranjbar Omrani

doi:10.1515/jpem-2019-0585

Artikel

Fibroblast growth factor 23 and its role in phosphate homeostasis in growing children compared to adults

Marjan Jeddi , Maryam Heidari , Neda Hatami und Gholam Hossein Ranjbar Omrani

Veröffentlicht/Copyright: 17. August 2020

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Aus der Zeitschrift Journal of Pediatric Endocrinology and Metabolism Band 33 Heft 8

Abstract

Objectives

Phosphate is essential for skeletal mineralization, which is regulated by parathyroid hormone, calcitriol and fibroblast growth factor 23 (FGF23). Serum phosphate is physiologically higher in younger children, but factors that contribute to this physiological state are poorly understood. This study aimed to evaluate phosphate and its regulators in children compared with adults.

Materials and methods

The participants were children aged 3–11 years and adults older than 20 years of age. Biochemical parameters including calcium, phosphorus, alkaline phosphatase, FGF23, and vitamin D were measured. Fractional excretion of phosphate was calculated, using serum and urine phosphate and creatinine.

Results

This cross-sectional study was conducted on 45 children (mean age: 9.0 ± 2.1) and 44 adults (mean age: 38.9 ± 11.1). The children had higher serum calcium, phosphate, alkaline phosphatase, and FGF23 (p < 0.001), but fractional excretion of phosphate was greater in adults (14.1 ± 5.7, 11.4 ± 4.4, p = 0.019, 95% confidence interval [CI]: −0.7 to −0.2). Of all individuals, 61.8% had vitamin D deficiency. By multiple regression analysis, entering age, calcium, phosphate, and vitamin D level, the only independent predictor of FGF23 was 1, 25 dihydroxy-vitamin D3 (β: 0.78, p < 0.001, 95% CI: 0.5–1.1, R²: 0.59 for children, and β: 0.59, p < 0.001, 95% CI: 0.5–1.4, R²: 0.45 for adults).

Conclusion

As far as we know, there is little information regarding the role of FGF23 in physiologic state. In this cross-sectional study no association was found between FGF23 and urinary phosphate excretion in growing children. Further studies with more detail are essential to evaluate phosphate homeostasis during childhood.

Keywords: children; fibroblast growth factor 23; phosphate

Corresponding author: Gholam Hossein Ranjbar Omrani, Endocrinology and Metabolism Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Postal Box 71345-1414, Shiraz, Iran, Fax: +98 7136473096, E-mail: hormone@sums.ac.ir.

Acknowledgment

The authors wish to thank Mr. H. Argasi at the Research Consultation Center (RCC) of Shiraz University of Medical Sciences for his invaluable assistance in editing this manuscript.

Research funding: No funding source.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Informed consent: Informed consent was obtained from the participants who were older than 18 and from parents of those who were under the age of 18.
Ethical approval: This study was approved by the local Ethics Committee of Shiraz University of Medical Science with the code number of 97-01-01-18408. The study protocol conformed to the ethical guidelines of the 1975 Helsinki Declaration and its later amendments.
Competing interests: The authors have no conflicts of interest relevant to this article to disclose.

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Received: 2019-12-16

Accepted: 2020-04-14

Published Online: 2020-08-17

Published in Print: 2020-08-27

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Artikel in diesem Heft

https://doi.org/10.1515/jpem-2019-0585

Schlagwörter für diesen Artikel

children; fibroblast growth factor 23; phosphate