Journal of Bone and Mineral Metabolism

, Volume 23, Issue 3, pp 231–237

The role of fibroblast growth factor 23 for hypophosphatemia and abnormal regulation of vitamin D metabolism in patients with McCune–Albright syndrome

  • Takehisa Yamamoto
  • Yasuo Imanishi
  • Eiichi Kinoshita
  • Yoshiko Nakagomi
  • Nobuhiko Shimizu
  • Akimitsu Miyauchi
  • Kenichi Satomura
  • Hiroyuki Koshiyama
  • Masaaki Inaba
  • Yoshiki Nishizawa
  • Harald Jüppner
  • Keiichi Ozono
ORIGINAL ARTICLE

Abstract

McCune–Albright syndrome (MAS) is sometimes complicated by hypophosphatemia and abnormally low levels of 1,25(OH)2D in the presence of hypophosphatemia. Recently, fibroblast growth factor 23 (FGF-23) was reported as a phosphaturic and a causal factor of abnormal vitamin D metabolism. This abnormal phosphate and vitamin D metabolism is well known to be found in oncogenic and X-linked hypophosphatemia. We furthermore reported increased circulating plasma FGF-23 levels in patients with oncogenic and X-linked hypophosphatemia. To determine whether FGF-23 may be involved in the pathogenesis of MAS, we measured plasma FGF-23 levels in six MAS patients. As a control for hypophosphatemia, we also investigated the plasma FGF-23 levels in two patients with hereditary hypophosphatemic rickets with hypercalciuria (HHRH). We also investigated the correlation of plasma FGF-23 levels with serum phosphate and 1,25(OH)2D levels after short-term pamidronate therapy in three MAS patients. Plasma FGF-23 levels were significantly increased in patients with MAS compared to normal controls, whereas they were not increased in HHRH patients. Serum phosphate levels of the MAS patients were significantly lower than those observed in normal controls. Plasma FGF-23 levels showed significant negative correlation with serum phosphate concentrations. In three MAS patients, pamidronate therapy decreased plasma FGF-23 levels, which showed significant negative correlation with serum 1,25(OH)2D concentrations. These data suggested that FGF-23 is a possible causal factor for hypophosphatemia and abnormal vitamin D metabolism in MAS.

Key words

Hypophosphatemia 1,25(OH)2Phosphatonin Pamidronate Hypophosphatemic rickets with hypercalciuria 

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Copyright information

© Springer-Verlag Tokyo 2005

Authors and Affiliations

  • Takehisa Yamamoto
    • 1
  • Yasuo Imanishi
    • 2
  • Eiichi Kinoshita
    • 3
  • Yoshiko Nakagomi
    • 4
  • Nobuhiko Shimizu
    • 5
  • Akimitsu Miyauchi
    • 6
  • Kenichi Satomura
    • 5
  • Hiroyuki Koshiyama
    • 7
  • Masaaki Inaba
    • 2
  • Yoshiki Nishizawa
    • 2
  • Harald Jüppner
    • 8
  • Keiichi Ozono
    • 9
  1. 1.Department of PediatricsMinoh City HospitalMinohJapan
  2. 2.Department of Metabolism, Endocrinology & Molecular MedicineOsaka City University Graduate School of MedicineOsakaJapan
  3. 3.Department of PediatricsNagasaki University School of MedicineNagasakiJapan
  4. 4.Department of PediatricsYamanashi University School of MedicineYamamashiJapan
  5. 5.Division of Pediatric Nephrology and MetabolismOsaka Medical Center and Research Institute for Maternal and Child HealthIzumiJapan
  6. 6.Department of Internal MedicineNational Hyogo Chuo HospitalHyogoJapan
  7. 7.Department of Internal MedicineMedical Institute Kitano HospitalOsakaJapan
  8. 8.Endocrine Unit, Department of Medicine, Mass General Hospital for ChildrenMassachusetts General Hospital and Harvard Medical SchoolBostonUSA
  9. 9.Department of PediatricsOsaka University Graduate School of MedicineOsakaJapan

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