Rheumatology International

, Volume 39, Issue 5, pp 835–840 | Cite as

Evaluation of serum fibroblast growth factor-23 in patients with axial spondyloarthritis and its association with sclerostin, inflammation, and spinal damage

  • Onay Gercik
  • Dilek Solmaz
  • Eyup Coban
  • Betul Ozbek Iptec
  • Gamze Avcioglu
  • Ozun Bayindir
  • Gokhan Kabadayi
  • Fatih Esad Topal
  • Didem Kozaci
  • Servet AkarEmail author
Observational Research


The mechanisms underlying new bone formation in individuals with axial spondyloarthritis (axSpA) remain unclear; however, low levels of sclerostin (SOST) may be associated with development of syndesmophytes in those with ankylosing spondylitis (AS). Expression of fibroblast growth factor-23 (FGF-23), another osteocyte factor, is high in those with osteoporosis and chronic renal failure, but levels in those with axSpA are unknown. To evaluate serum FGF-23 and SOST levels in axSpA patients, and to assess their relationship with inflammation and structural damage. In total, 109 axSpA patients (55 with AS and 54 with non-radiographic axSpA) and 57 healthy control (HC) subjects were included in the analysis. Serum concentrations of FGF-23 and SOST were measured and correlation analysis was performed. The presence of syndesmophytes and the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS) were used to assess structural damage. Levels of serum FGF-23 in axSpA patients were significantly higher than those in HCs [median (interquartile range—IQR) FGF-23 level, pg/ml; AxSpA = 144 (82.3–253.2), HC = 107 (63.3–192.8), p = 0.010]; however, there was no difference in SOST levels. FGF-23 levels correlated with the erythrocyte sedimentation rate (ESR) (r = 0.265, p = 0.006) and serum C-reactive protein (CRP) level (r = 0.229, p = 0.010). In the axSpA, SOST levels correlated negatively with mSASSS (r = − 0.283, p = 0.007), whereas those in the AS group correlated negatively with CRP (r = − 0.426, p = 0.001). Serum FGF-23 levels were high in axSpA patients. Increased FGF-23 was associated with inflammation, but not with SOST levels or disease activity. SOST correlated negatively with both inflammation and structural damage.


Fibroblast growth factor-23 Sclerostin Spondyloarthritis Ankylosing spondylitis 



This manuscript was edited by pre-peer review service.

Author contributions

All co-authors meet the authorship criteria based on ICMJE. Study design: OG, DS, DK, SA. Acquisition of data: OG, DS, EC, BOI, GA, OB, GK, FET, SA. Analysis and interpretation of data: DS, EC, BOI, GA, OB, GK, FET, DK, SA. Drafting the article or revising: OG, DS, EC, BOI, GA, OB, GK, FET, DK, SA. Final approval of the version of the article to be published: OG, DS, EC, BOI, GA, OB, GK, FET, DK, SA.


This study was supported by Scientific Research Projects Coordination Unit of Izmir Katip Celebi University. Project number: 2016-TDU-TIPF-0020.

Compliance with ethical standards

Conflict of interest

None for all authors.

Ethics approval

Ethics approval was obtained from the local ethical committee [Izmir Katip Celebi University Ethics Board, Izmir, Turkey (approval number: 27/2016)]. Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Internal Medicine, Division of Rheumatology, Faculty of MedicineIzmir Katip Celebi UniversityIzmirTurkey
  2. 2.Department of Medical Biochemistry, Faculty of MedicineAnkara Yıldırım Beyazıt UniversityAnkaraTurkey
  3. 3.Department of Internal Medicine, Faculty of MedicineIzmir Katip Celebi UniversityIzmirTurkey
  4. 4.Department of Emergency Medicine, Faculty of MedicineIzmir Katip Celebi UniversityIzmirTurkey

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