Fibroblast growth factor 23, mineral metabolism, and adiposity in normal kidney function

Sarah Zaheer, Ian H. De Boer, Matthew Allison, Jenifer M. Brown, Bruce M. Psaty, Cassianne Robinson-Cohen, Erin Donnelly Michos, Joachim H. Ix, Bryan Kestenbaum, David Siscovick, Anand Vaidya

Research output: Contribution to journalArticle

Abstract

Context: Obesity is associated with poor bone mineralization and quality. Fibroblast growth factor 23 (FGF23) plays an important role in skeletal physiology. Objective: To test hypothesis that greater adiposity results in higher FGF23 levels among individuals with normal estimated glomerular filtration rate (eGFR). Design, Setting, Participants: Cross-sectional analyses among participants with eGFR ≥60 mL/min/ 1.73m2.We assessed the association between crude [body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR); n = 5610] and refined (abdominal adipose tissue area by computed tomography; n = 1313) measures of adiposity and FGF23 using multivariable linear regression. Main Outcome Measure: Serum FGF23. Results: FGF23 was higher across BMI categories (BMI <25: 37.7; BMI 25 to 29.99: 38.7; BMI 30 to 39.99: 39.8; BMI ≥40: 40.9 pg/mL, unadjusted P trend < 0.0001). The association between BMI and FGF23 was independent of known confounders of FGF23 (adjusted β = +7.2% higher FGF23 per 10 kg/m2; P < 0.0001). Similar results were observed using WC and WHR. Abdominal adipose tissue area was also independently associated with higher FGF23 (P < 0.01). Notably, the positive associations between FGF23 and adiposity were observed despite the fact that eGFR did not decline and serum phosphate levels did not increase with adiposity. Conclusion: In a large cohort with normal kidney function, adiposity was associated with higher FGF23 levels independent of known confounders, including eGFR and phosphate. Further studies are needed to evaluate the causes of higher FGF23 in settings of greater adiposity and the potential impact on skeletal health.

Original languageEnglish (US)
Pages (from-to)1387-1395
Number of pages9
JournalJournal of Clinical Endocrinology and Metabolism
Volume102
Issue number4
DOIs
StatePublished - Apr 1 2017

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Adiposity
Metabolism
Minerals
Kidney
Body Mass Index
Glomerular Filtration Rate
Abdominal Fat
Waist-Hip Ratio
Waist Circumference
fibroblast growth factor 23
Phosphates
Tissue
Physiologic Calcification
Physiology
Serum
Linear regression
Tomography
Linear Models
Bone
Obesity

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Zaheer, S., De Boer, I. H., Allison, M., Brown, J. M., Psaty, B. M., Robinson-Cohen, C., ... Vaidya, A. (2017). Fibroblast growth factor 23, mineral metabolism, and adiposity in normal kidney function. Journal of Clinical Endocrinology and Metabolism, 102(4), 1387-1395. https://doi.org/10.1210/jc.2016-3563

Fibroblast growth factor 23, mineral metabolism, and adiposity in normal kidney function. / Zaheer, Sarah; De Boer, Ian H.; Allison, Matthew; Brown, Jenifer M.; Psaty, Bruce M.; Robinson-Cohen, Cassianne; Michos, Erin Donnelly; Ix, Joachim H.; Kestenbaum, Bryan; Siscovick, David; Vaidya, Anand.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 102, No. 4, 01.04.2017, p. 1387-1395.

Research output: Contribution to journalArticle

Zaheer, S, De Boer, IH, Allison, M, Brown, JM, Psaty, BM, Robinson-Cohen, C, Michos, ED, Ix, JH, Kestenbaum, B, Siscovick, D & Vaidya, A 2017, 'Fibroblast growth factor 23, mineral metabolism, and adiposity in normal kidney function', Journal of Clinical Endocrinology and Metabolism, vol. 102, no. 4, pp. 1387-1395. https://doi.org/10.1210/jc.2016-3563
Zaheer, Sarah ; De Boer, Ian H. ; Allison, Matthew ; Brown, Jenifer M. ; Psaty, Bruce M. ; Robinson-Cohen, Cassianne ; Michos, Erin Donnelly ; Ix, Joachim H. ; Kestenbaum, Bryan ; Siscovick, David ; Vaidya, Anand. / Fibroblast growth factor 23, mineral metabolism, and adiposity in normal kidney function. In: Journal of Clinical Endocrinology and Metabolism. 2017 ; Vol. 102, No. 4. pp. 1387-1395.
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abstract = "Context: Obesity is associated with poor bone mineralization and quality. Fibroblast growth factor 23 (FGF23) plays an important role in skeletal physiology. Objective: To test hypothesis that greater adiposity results in higher FGF23 levels among individuals with normal estimated glomerular filtration rate (eGFR). Design, Setting, Participants: Cross-sectional analyses among participants with eGFR ≥60 mL/min/ 1.73m2.We assessed the association between crude [body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR); n = 5610] and refined (abdominal adipose tissue area by computed tomography; n = 1313) measures of adiposity and FGF23 using multivariable linear regression. Main Outcome Measure: Serum FGF23. Results: FGF23 was higher across BMI categories (BMI <25: 37.7; BMI 25 to 29.99: 38.7; BMI 30 to 39.99: 39.8; BMI ≥40: 40.9 pg/mL, unadjusted P trend < 0.0001). The association between BMI and FGF23 was independent of known confounders of FGF23 (adjusted β = +7.2{\%} higher FGF23 per 10 kg/m2; P < 0.0001). Similar results were observed using WC and WHR. Abdominal adipose tissue area was also independently associated with higher FGF23 (P < 0.01). Notably, the positive associations between FGF23 and adiposity were observed despite the fact that eGFR did not decline and serum phosphate levels did not increase with adiposity. Conclusion: In a large cohort with normal kidney function, adiposity was associated with higher FGF23 levels independent of known confounders, including eGFR and phosphate. Further studies are needed to evaluate the causes of higher FGF23 in settings of greater adiposity and the potential impact on skeletal health.",
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AU - Robinson-Cohen, Cassianne

AU - Michos, Erin Donnelly

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N2 - Context: Obesity is associated with poor bone mineralization and quality. Fibroblast growth factor 23 (FGF23) plays an important role in skeletal physiology. Objective: To test hypothesis that greater adiposity results in higher FGF23 levels among individuals with normal estimated glomerular filtration rate (eGFR). Design, Setting, Participants: Cross-sectional analyses among participants with eGFR ≥60 mL/min/ 1.73m2.We assessed the association between crude [body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR); n = 5610] and refined (abdominal adipose tissue area by computed tomography; n = 1313) measures of adiposity and FGF23 using multivariable linear regression. Main Outcome Measure: Serum FGF23. Results: FGF23 was higher across BMI categories (BMI <25: 37.7; BMI 25 to 29.99: 38.7; BMI 30 to 39.99: 39.8; BMI ≥40: 40.9 pg/mL, unadjusted P trend < 0.0001). The association between BMI and FGF23 was independent of known confounders of FGF23 (adjusted β = +7.2% higher FGF23 per 10 kg/m2; P < 0.0001). Similar results were observed using WC and WHR. Abdominal adipose tissue area was also independently associated with higher FGF23 (P < 0.01). Notably, the positive associations between FGF23 and adiposity were observed despite the fact that eGFR did not decline and serum phosphate levels did not increase with adiposity. Conclusion: In a large cohort with normal kidney function, adiposity was associated with higher FGF23 levels independent of known confounders, including eGFR and phosphate. Further studies are needed to evaluate the causes of higher FGF23 in settings of greater adiposity and the potential impact on skeletal health.

AB - Context: Obesity is associated with poor bone mineralization and quality. Fibroblast growth factor 23 (FGF23) plays an important role in skeletal physiology. Objective: To test hypothesis that greater adiposity results in higher FGF23 levels among individuals with normal estimated glomerular filtration rate (eGFR). Design, Setting, Participants: Cross-sectional analyses among participants with eGFR ≥60 mL/min/ 1.73m2.We assessed the association between crude [body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR); n = 5610] and refined (abdominal adipose tissue area by computed tomography; n = 1313) measures of adiposity and FGF23 using multivariable linear regression. Main Outcome Measure: Serum FGF23. Results: FGF23 was higher across BMI categories (BMI <25: 37.7; BMI 25 to 29.99: 38.7; BMI 30 to 39.99: 39.8; BMI ≥40: 40.9 pg/mL, unadjusted P trend < 0.0001). The association between BMI and FGF23 was independent of known confounders of FGF23 (adjusted β = +7.2% higher FGF23 per 10 kg/m2; P < 0.0001). Similar results were observed using WC and WHR. Abdominal adipose tissue area was also independently associated with higher FGF23 (P < 0.01). Notably, the positive associations between FGF23 and adiposity were observed despite the fact that eGFR did not decline and serum phosphate levels did not increase with adiposity. Conclusion: In a large cohort with normal kidney function, adiposity was associated with higher FGF23 levels independent of known confounders, including eGFR and phosphate. Further studies are needed to evaluate the causes of higher FGF23 in settings of greater adiposity and the potential impact on skeletal health.

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