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Serum FGF23 levels may not be associated with serum phosphate and 1,25-dihydroxyvitamin D levels in patients with Fanconi syndrome – induced hypophosphatemia

View Article: PubMed Central - PubMed

ABSTRACT

Fibroblast growth factor 23 (FGF23) is regulated by sustained phosphate supplementation and restriction. However, few studies have investigated FGF23 levels in patients with Fanconi syndrome. Therefore, we evaluated intact and C-terminal FGF23 and FGF23-associated parameters in four patients with Fanconi syndrome. Serum intact and C-terminal FGF23 levels were extremely low. Although serum phosphate and 1,25-dihydroxyvitamin D levels improved to or above the normal range within 1 year of treatment with oral phosphate and calcitriol, serum FGF23 levels remained low. Serum FGF23 levels in patients with Fanconi syndrome might be regulated by novel factors other than serum phosphate and 1,25-dihydroxyvitamin D levels.

No MeSH data available.


Changes in serum intact FGF23 and C-terminal FGF23 levels.
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SFW086F1: Changes in serum intact FGF23 and C-terminal FGF23 levels.

Mentions: Changes in serum intact FGF23 and C-terminal FGF23 levels are shown in Figure 1. Intact FGF23 levels were measured using a chemiluminescence immunoassay (Kyowa Medex, Shizuoka, Japan) and C-terminal FGF23 levels were measured using a C-terminal FGF23 ELISA kit (Biomedica Immunoassays, Vienna, Austria). The normal ranges of these assays were defined according to previous reports or the manufacturer's data [7–10]. At baseline, serum intact FGF23 and C-terminal FGF23 levels were very low, and in three cases they were below the lower limit of detection. Three months after starting treatment, serum intact FGF23 (with the exception of patient 3) and C-terminal FGF23 levels remained below the normal range, although serum phosphate and 1,25-dihydroxyvitamin D levels were within or above the normal range. One year after starting treatment, serum intact FGF23 levels in patient 2 and C-terminal FGF23 in patients 2 and 3 remained below the normal range. Additionally, we measured serum intact FGF23 levels at each time point using a human intact FGF23 ELISA kit (Kainos Laboratories, Tokyo, Japan), an assay that is commonly used to measure intact FGF23. The results of this assay demonstrated that intact FGF23 levels in all patients were below the lower limit of detection at baseline and 3 months after starting treatment. In patients 1, 2 and 4, FGF23 levels remained below the lower limit of detection 1 year after starting treatment.Fig. 1.


Serum FGF23 levels may not be associated with serum phosphate and 1,25-dihydroxyvitamin D levels in patients with Fanconi syndrome – induced hypophosphatemia
Changes in serum intact FGF23 and C-terminal FGF23 levels.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5036911&req=5

SFW086F1: Changes in serum intact FGF23 and C-terminal FGF23 levels.
Mentions: Changes in serum intact FGF23 and C-terminal FGF23 levels are shown in Figure 1. Intact FGF23 levels were measured using a chemiluminescence immunoassay (Kyowa Medex, Shizuoka, Japan) and C-terminal FGF23 levels were measured using a C-terminal FGF23 ELISA kit (Biomedica Immunoassays, Vienna, Austria). The normal ranges of these assays were defined according to previous reports or the manufacturer's data [7–10]. At baseline, serum intact FGF23 and C-terminal FGF23 levels were very low, and in three cases they were below the lower limit of detection. Three months after starting treatment, serum intact FGF23 (with the exception of patient 3) and C-terminal FGF23 levels remained below the normal range, although serum phosphate and 1,25-dihydroxyvitamin D levels were within or above the normal range. One year after starting treatment, serum intact FGF23 levels in patient 2 and C-terminal FGF23 in patients 2 and 3 remained below the normal range. Additionally, we measured serum intact FGF23 levels at each time point using a human intact FGF23 ELISA kit (Kainos Laboratories, Tokyo, Japan), an assay that is commonly used to measure intact FGF23. The results of this assay demonstrated that intact FGF23 levels in all patients were below the lower limit of detection at baseline and 3 months after starting treatment. In patients 1, 2 and 4, FGF23 levels remained below the lower limit of detection 1 year after starting treatment.Fig. 1.

View Article: PubMed Central - PubMed

ABSTRACT

Fibroblast growth factor 23 (FGF23) is regulated by sustained phosphate supplementation and restriction. However, few studies have investigated FGF23 levels in patients with Fanconi syndrome. Therefore, we evaluated intact and C-terminal FGF23 and FGF23-associated parameters in four patients with Fanconi syndrome. Serum intact and C-terminal FGF23 levels were extremely low. Although serum phosphate and 1,25-dihydroxyvitamin D levels improved to or above the normal range within 1 year of treatment with oral phosphate and calcitriol, serum FGF23 levels remained low. Serum FGF23 levels in patients with Fanconi syndrome might be regulated by novel factors other than serum phosphate and 1,25-dihydroxyvitamin D levels.

No MeSH data available.