Regulation of plasma fibroblast growth factor 23 by calcium in primary hyperparathyroidism

被引:82
作者
Kobayashi, K
Imanishi, Y
Miyauchi, A
Onoda, N
Kawata, T
Tahara, H
Goto, H
Miki, T
Ishimura, E
Sugimoto, T
Ishikawa, T
Inaba, M
Nishizawa, Y
机构
[1] Osaka City Univ, Grad Sch Med, Dept Metab Endocrinol & Mol Med, Abeno Ku, Osaka 5458585, Japan
[2] Natl Hyogo Chuo Hosp, Hyogo, Japan
[3] Osaka City Univ, Grad Sch Med, Dept Oncol, Osaka 558, Japan
[4] Osaka City Univ, Grad Sch Med, Dept Geriatr & Neurol, Osaka 558, Japan
[5] Shimane Univ, Sch Med, Dept Med, Div Endocrinol Metab Hematol & Oncol, Matsue, Shimane, Japan
[6] Osaka City Univ, Grad Sch Med, Dept Surg Oncol, Osaka 558, Japan
关键词
D O I
10.1530/eje.1.02053
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: While the importance of fibroblast growth factor (FGF)-23 is established in phosphate-wasting disorders, little is known about the mechanisms regulating its circulating level. To investigate the role of parathyroid hormone (PTH) and calcium in FGF-23 metabolism, we examined plasma FGF-23 levels in patients with primary hyperparathyroidism (PHPT). Patients and methods: Fifty patients with PHPT and 52 controls were employed in this study. Plasma was obtained from 18 PHPT patients who underwent parathyroidectomy (PTX) on the first postoperative morning without vitamin D administration. Time-course samples were also obtained from 5 of 18 PTX patients without vitamin D analogs or calcium administration. The expression of Fgf23 on resected parathyroid glands was analyzed by reverse transcription (RT)-PCR and immunohistochemistry. Results: FGF-23 was significantly elevated in PHPT patients compared with controls. FGF-23 levels were significantly correlated positively with serum corrected calcium and intact PTH levels. and negatively with creatinine clearance and inorganic phosphate. among which creatinine clearance and corrected calcium were independently associated factors. In 18 PTX patients, postoperative FGF-23 levels were significantly decreased compared with preoperative levels. Corrected-calcium levels were significantly decreased 1 h after PTX. and this was followed by a reduction in plasma FGF-23 levels in time-course study. In addition, postoperative FGF-23 levels in 18 PTX patients were significantly correlated with corrected calcium, consistent with a role of serum calcium as one of the major regulators of FGF-23. The absence of Fgf23 expression in parathyroid glands indicated that the parathyroid glands were not major sources of circulating FGF-23. Conclusions: Serum calcium may regulate circulating FGF-23 levels in PHPT.
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页码:93 / 99
页数:7
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