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High Circulating FGF-23 and Its Relationship with Severity of Spinal Involvement in Diffuse Idiopathic Skeletal Hyperostosis

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Abstract

The primary objective of this study was to determine the role of fibroblast growth factor 23 (FGF-23) in the pathogenesis of diffuse idiopathic skeletal hyperostosis (DISH). A total of 61 patients with DISH and 61 age- and sex-matched control patients without DISH were included in this study. The serum FGF-23, creatinine, inorganic phosphate, calcium, albumin, albumin-adjusted calcium and alkaline phosphatase, and C-reactive protein were assessed in both groups. Based on the extent of ossification, DISH group was further divided into T-DISH and L-DISH subgroups. Data were comparatively analyzed between DISH and Non-DISH groups and among T-DISH, L-DISH, and Non-DISH groups, respectively. Besides, the number of ossification segments of all DISH patients was quantified and the correlation between the number of ossification segments and the serum concentration of FGF-23 was analyzed. The results revealed that serum FGF-23 was significantly higher in DISH group than in Non-DISH group, regardless of gender. Interestingly, serum Pi was significantly lower in DISH group than in Non-DISH group. Moreover, a significant difference in serum FGF-23 among T-DISH, L-DISH, and Non-DISH groups was also observed. In contrast to Non-DISH group, both T-DISH and L-DISH subgroups displayed significantly higher serum FGF-23 level. Although the mean value was relatively higher in L-DISH subgroup, no statistically significant difference was found between T-DISH and L-DISH subgroups. In addition, a moderately positive correlation was identified between the number of ossification segments and the serum level of FGF-23. It can be concluded that serum FGF-23 could serve as a positive biomarker for DISH and may play a significant role in ectopic ossification in DISH.

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Data Availability

The datasets generated during and/or analyzed during the current study are not publicly available but are available from the corresponding author on reasonable request.

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Acknowledgements

The authors thank all the patients who participated in this study and the staff from the Drum Tower Hospital, Nanjing, China.

Funding

This study was supported by the National Natural Science Foundation of China (61971216), the Key Research and Development Project of Jiangsu Province (BE2022692 and BE2020768), and the Nanjing Science and Technology Development Plan Project (202205066).

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Author notes

  1. Haicheng Zhou and Hongpan Xu have contributed equally to this work and share first authorship.

Authors and Affiliations

  1. Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Zhongshan Road 321, Nanjing, 210008, China

    Haicheng Zhou & Xu Sun

  2. Department of Clinical Laboratory, Nanjing Drum Tower Hospital Clinical College of Jiangsu University, Zhongshan Road 321, Nanjing, 210008, China

    Hongpan Xu & Zhiyang Li

  3. College of Life Science, Yangtze University, Jingzhou, China

    Jianmin Gong

Authors
  1. Haicheng Zhou
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  2. Hongpan Xu
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  3. Jianmin Gong
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  5. Xu Sun
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Contributions

HZ contributed to data collection, performed the study and data analysis, drafted the main manuscript, and provided the final approval for submission. HX contributed to data collection and performed the study and data analysis. JG contributed to data collection. XS and ZL contributed to the study design, reviewed the manuscript critically for important intellectual content, and provided the final approval for submission.

Corresponding authors

Correspondence to Zhiyang Li or Xu Sun.

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Conflict of interest

All authors have no conflicts of interest to declare.

Human and Animal Rights and Informed Consent

The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013). The study was approved by our institutional review board (No. 2021-LCYJ-DBZ-05). All volunteers were fully informed about the methods, purposes, and risks involved in the study protocol and signed the informed consent. No animal studies were performed in the course of these experiments.

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Informed consent was obtained from all individual participants included in the study.

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Zhou, H., Xu, H., Gong, J. et al. High Circulating FGF-23 and Its Relationship with Severity of Spinal Involvement in Diffuse Idiopathic Skeletal Hyperostosis. Calcif Tissue Int 113, 526–531 (2023). https://doi.org/10.1007/s00223-023-01134-8

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  • DOI: https://doi.org/10.1007/s00223-023-01134-8

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