Serum fibroblast growth factor-23 (FGF-23) and fracture risk in elderly men

Majd A I Mirza, Magnus K. Karlsson, Dan Mellström, Eric Orwoll, Claes Ohlsson, Östen Ljunggren, Tobias E. Larsson

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

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 (Pi) and 1,25-dihydroxyvitamin D3 [1,25(OH)2D3]. 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 55.7pg/mL. FGF-23 levels above 55.7pg/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)2D 3, parathyroid hormone (PTH), and other fracture risk factors. In conclusion, FGF-23 is a novel predictor of fracture risk in elderly men.

Original languageEnglish (US)
Pages (from-to)857-864
Number of pages8
JournalJournal of Bone and Mineral Research
Volume26
Issue number4
DOIs
StatePublished - Apr 2011

Fingerprint

Serum
Confidence Intervals
fibroblast growth factor 23
Osteoporotic Fractures
Calcitriol
Bone Development
Hip Fractures
Parathyroid Hormone
Glomerular Filtration Rate
Bone Density
Minerals
Enzyme-Linked Immunosorbent Assay
Odds Ratio
Monoclonal Antibodies
Bone and Bones
Incidence
Population

Keywords

  • BMD
  • bone mineral density
  • calcitriol
  • FGF-23
  • fractures
  • osteomalacia
  • rickets
  • vitamin D

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Mirza, M. A. I., Karlsson, M. K., Mellström, D., Orwoll, E., Ohlsson, C., Ljunggren, Ö., & Larsson, T. E. (2011). Serum fibroblast growth factor-23 (FGF-23) and fracture risk in elderly men. Journal of Bone and Mineral Research, 26(4), 857-864. https://doi.org/10.1002/jbmr.263

Serum fibroblast growth factor-23 (FGF-23) and fracture risk in elderly men. / Mirza, Majd A I; Karlsson, Magnus K.; Mellström, Dan; Orwoll, Eric; Ohlsson, Claes; Ljunggren, Östen; Larsson, Tobias E.

In: Journal of Bone and Mineral Research, Vol. 26, No. 4, 04.2011, p. 857-864.

Research output: Contribution to journalArticle

Mirza, MAI, Karlsson, MK, Mellström, D, Orwoll, E, Ohlsson, C, Ljunggren, Ö & Larsson, TE 2011, 'Serum fibroblast growth factor-23 (FGF-23) and fracture risk in elderly men', Journal of Bone and Mineral Research, vol. 26, no. 4, pp. 857-864. https://doi.org/10.1002/jbmr.263
Mirza, Majd A I ; Karlsson, Magnus K. ; Mellström, Dan ; Orwoll, Eric ; Ohlsson, Claes ; Ljunggren, Östen ; Larsson, Tobias E. / Serum fibroblast growth factor-23 (FGF-23) and fracture risk in elderly men. In: Journal of Bone and Mineral Research. 2011 ; Vol. 26, No. 4. pp. 857-864.
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