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Fibroblast Growth Factor 23 as Regulator of Vitamin D Metabolism

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Phosphate Metabolism

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 1362))

Abstract

Fibroblast growth factor 23 (FGF23) is a hormone produced by osteocytes in bone that acts on the kidneys to regulate phosphate and vitamin D metabolism.FGF23 levels were shown to be increased in the early stage of chronic kidney disease (CKD), with a slight decline in estimated glomerular filtration rate (eGFR) even when the range was restricted to above 60 mL/min/1.73 m2, indicating that subtle phosphate load is a stimulator of FGF23 in serum. FGF23 is also known to inhibit vitamin D activation from 25-hydroxyvitamin D (25-OH-D) to 1,25-dihydroxyvitamin D [1,25(OH)2D], while it stimulates its degradation from 25-OH-D to 24,25-dihydroxyvitamin D [24,25(OH)2D]. Previously, we demonstrated a significant and negative association of serum FGF23 with serum 1,25(OH)2D and 1,25(OH)2D/25-OH-D ratio, a putative parameter for CYP27B1, and confirmed the physiological effects of FGF23 on phosphate and vitamin D metabolism in non-CKD subjects. Elevated FGF23 by itself is reported to be associated with various adverse outcomes, including left ventricular hypertrophy, endothelial dysfunction, and activation of the renin-angiotensin-aldosterone system, leading to increased mortality even in non-CKD individuals. On the other hand, our previous study showed that the impaired incremental response of serum FGF23 in response to oral phosphate load in diabetic patients can help to significantly increase serum phosphate (Yoda et al., J Clin Endocrinol Metab 97:E2036–43, 2012) and thus may contribute to progression of vascular calcification in those patients (personal observation). It is suggested that increased serum FGF23 might be an important indicator of adverse outcomes in non-CKD as well as CKD patients.

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Acknowledgments

We want to express our sincere gratitude to Dr. Nuraly Akimbekov, Ph.D. (Al-Farabi Kazakh National University, Kazakhstan), to help draw the illustrations.

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  1. Authors Shinya Nakatani and Masaaki Inaba have equally contributed to this chapter.

Authors and Affiliations

  1. Department of Metabolism, Endocrinology, and Molecular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan

    Shinya Nakatani, Ayumi Nakatani, Masanori Emoto & Masaaki Inaba

  2. Department of Nephrology, Osaka City University Graduate School of Medicine, Osaka, Japan

    Katsuhito Mori & Masaaki Inaba

  3. Department of Pathology, Lake Erie College of Osteopathic Medicine, Erie, PA, USA

    Mohammed S. Razzaque

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  1. Shinya Nakatani
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Correspondence to Shinya Nakatani .

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  1. Professor of Pathology, Lake Erie College of Osteopathic Medicine, Erie, PA, USA

    Mohammed S. Razzaque

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Nakatani, S., Nakatani, A., Mori, K., Emoto, M., Inaba, M., Razzaque, M.S. (2022). Fibroblast Growth Factor 23 as Regulator of Vitamin D Metabolism. In: Razzaque, M.S. (eds) Phosphate Metabolism . Advances in Experimental Medicine and Biology, vol 1362. Springer, Cham. https://doi.org/10.1007/978-3-030-91623-7_6

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