Fibroblast Growth Factor 23, Bone Mineral Density, and Risk of Hip Fracture Among Older Adults: the Cardiovascular Health Study

Overview

Journal J Clin Endocrinol Metab

Publisher Oxford University Press

Specialty Endocrinology

Date 2013 Jun 18

PMID 23771921

Citations 24

Authors

Anna Jovanovich

Petra Buzkova

Michel Chonchol

John Robbins

Howard A Fink

Ian H de Boer

Bryan Kestenbaum

Ronit Katz

Laura Carbone

Jennifer Lee

Gail A Laughlin

Kenneth J Mukamal

Linda F Fried

Michael G Shlipak

Joachim H Ix

Affiliations

Soon will be listed here.

Abstract

Context: Fibroblast growth factor 23 (FGF23) is a phosphaturic hormone that also inhibits calcitriol synthesis.

Objective: Our objective was to evaluate the relationships of plasma FGF23 concentrations with bone mineral density (BMD) and hip fracture in community-dwelling older adults.

Design And Setting: Linear regression and Cox proportional hazard models were used to examine the associations of plasma FGF23 concentrations with BMD and incident hip fracture, respectively. Analyses were also stratified by chronic kidney disease.

Participants: Participants included 2008 women and 1329 men ≥65 years from the 1996 to 1997 Cardiovascular Health Study visit.

Main Outcome Measures: Dual x-ray absorptiometry measured total hip (TH) and lumbar spine (LS) BMD in 1291 participants. Hip fracture incidence was assessed prospectively through June 30, 2008 by hospitalization records in all participants.

Results: Women had higher plasma FGF23 concentrations than men (75 [56-107] vs 66 [interquartile range = 52-92] relative units/mL; P < .001). After adjustment, higher FGF23 concentrations were associated with greater total hip and lumbar spine BMD in men only (β per doubling of FGF23 = 0.02, with 95% confidence interval [CI] = 0.001-0.04 g/cm(2), and 0.03 with 95% CI = 0.01-0.06 g/cm(2)). During 9.6 ± 5.1-11.0 years of follow-up, 328 hip fractures occurred. Higher FGF23 concentrations were not associated with hip fracture risk in women or men (adjusted hazard ratio = 0.95, with 95% CI = 0.78-1.15, and 1.09 with 95% CI = 0.82-1.46 per doubling of FGF23). Results did not differ by chronic kidney disease status (P > .4 for interactions).

Conclusions: In this large prospective cohort of community-dwelling older adults, higher FGF23 concentrations were weakly associated with greater lumbar spine and total hip BMD but not with hip fracture risk.

Citing Articles

Association of aberrant mineral metabolic markers with fracture risk in chronic kidney disease: a comprehensive meta-analysis.

Liu Y, Zhang Z, Fu C, Ye Z, Jin H, Yang X BMC Nephrol. 2025; 26(1):68.

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Targeted Deletion of Fibroblast Growth Factor 23 Rescues Metabolic Dysregulation of Diet-induced Obesity in Female Mice.

Park M, Tu C, Perie L, Verma N, Serdan T, Shamsi F Endocrinology. 2024; 165(12).

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Interrelationships among metabolic syndrome, bone-derived cytokines, and the most common metabolic syndrome-related diseases negatively affecting bone quality.

Martiniakova M, Mondockova V, Kovacova V, Babikova M, Zemanova N, Biro R Diabetol Metab Syndr. 2024; 16(1):217.

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Serum Intact Fibroblast Growth Factor 23 Levels Are Negatively Associated with Bone Mineral Density in Chronic Hemodialysis Patients.

Lee W, Fang Y, Chen M, Liou H, Lee C, Tsai M J Clin Med. 2023; 12(4).

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Biomarkers of Vitamin D Metabolism and Hip and Vertebral Fracture Risk: The Multi-Ethnic Study of Atherosclerosis.

Hsu S, Criqui M, Ginsberg C, Hoofnagle A, Ix J, McClelland R JBMR Plus. 2022; 6(12):e10697.

PMID: 36530185 PMC: 9751658. DOI: 10.1002/jbm4.10697.

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