open access

Vol 71, No 4 (2020)
Original paper
Published online: 2020-05-22
Submitted: 2020-02-05
Accepted: 2020-04-28
Get Citation

FGF23 and primary hyperparathyroidism: is there a link?

Stefana Catalina Bilha, Alina Andreea Gatu, Cristian Velicescu, Andrei Bilha, Alexandru Florescu, Dumitru Branisteanu
DOI: 10.5603/EP.a2020.0030
·
Pubmed: 32598019
·
Endokrynologia Polska 2020;71(4):306-312.

open access

Vol 71, No 4 (2020)
Original Paper
Published online: 2020-05-22
Submitted: 2020-02-05
Accepted: 2020-04-28

Abstract

Introduction: Data regarding the role of fibroblast growth factor 23 (FGF23) in primary hyperparathyroidism (PHPT) are scarce and discordant. Our study aimed to evaluate the prognostic impact of FGF23 upon the clinical and biochemical evolution of PHPT.

Material and methods: Forty-two patients with ages between 30 and 80 years, diagnosed with PHPT caused by a sporadic, solitary parathyroid adenoma, and referred to surgery (minimally invasive parathyroidectomy) were prospectively included in the study. Serum levels of FGF23, PTH, 25(OH)D3, calcium (Ca), phosphate (P), total procollagen type 1 N-terminal propeptide, and C-terminal telopeptide of type I collagen were determined at baseline (preoperatory), one day after surgery, and in 13 patients also prospectively at three, six, and 12 months. Bone mineral density (BMD) was also evaluated before surgery in all patients and 12 months after surgery in the 13
followed up patients.

Results: In the 42 PHPT patients with D hypovitaminosis (mean 25(OH)D3 levels of 16.2 ± 1.5 ng/mL), preoperatory serum FGF23 concentration was within the normal range (75.55 ± 3.39 pg/mL) and remained unchanged one day post operation (81.69 ± 4.67 pg/mL, p = non-significant). The 13 patients followed prospectively for up to 12 months after surgery also showed unmodified FGF23 levels (80.9 ± 11.03 pg/mL, p = non-significant), despite PTH and Ca normalisation and vitamin D replenishment. Preoperatory FGF23 negatively correlated with PTH (r = –0.37, p = 0.038), but not with 25(OH)D3, Ca, P, bone mass, or metabolism markers.

Conclusions: In PHPT, correlations between FGF23 and PTH seem rather an epiphenomenon. Therefore, we think that FGF23 evaluation and dynamics are not informative regarding PHPT severity. (Endokrynol Pol 2020; 71 (4): 306–312)

Abstract

Introduction: Data regarding the role of fibroblast growth factor 23 (FGF23) in primary hyperparathyroidism (PHPT) are scarce and discordant. Our study aimed to evaluate the prognostic impact of FGF23 upon the clinical and biochemical evolution of PHPT.

Material and methods: Forty-two patients with ages between 30 and 80 years, diagnosed with PHPT caused by a sporadic, solitary parathyroid adenoma, and referred to surgery (minimally invasive parathyroidectomy) were prospectively included in the study. Serum levels of FGF23, PTH, 25(OH)D3, calcium (Ca), phosphate (P), total procollagen type 1 N-terminal propeptide, and C-terminal telopeptide of type I collagen were determined at baseline (preoperatory), one day after surgery, and in 13 patients also prospectively at three, six, and 12 months. Bone mineral density (BMD) was also evaluated before surgery in all patients and 12 months after surgery in the 13
followed up patients.

Results: In the 42 PHPT patients with D hypovitaminosis (mean 25(OH)D3 levels of 16.2 ± 1.5 ng/mL), preoperatory serum FGF23 concentration was within the normal range (75.55 ± 3.39 pg/mL) and remained unchanged one day post operation (81.69 ± 4.67 pg/mL, p = non-significant). The 13 patients followed prospectively for up to 12 months after surgery also showed unmodified FGF23 levels (80.9 ± 11.03 pg/mL, p = non-significant), despite PTH and Ca normalisation and vitamin D replenishment. Preoperatory FGF23 negatively correlated with PTH (r = –0.37, p = 0.038), but not with 25(OH)D3, Ca, P, bone mass, or metabolism markers.

Conclusions: In PHPT, correlations between FGF23 and PTH seem rather an epiphenomenon. Therefore, we think that FGF23 evaluation and dynamics are not informative regarding PHPT severity. (Endokrynol Pol 2020; 71 (4): 306–312)

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Keywords

FGF23; PTH; vitamin D; parathyroid adenoma; bone

About this article
Title

FGF23 and primary hyperparathyroidism: is there a link?

Journal

Endokrynologia Polska

Issue

Vol 71, No 4 (2020)

Article type

Original paper

Pages

306-312

Published online

2020-05-22

DOI

10.5603/EP.a2020.0030

Pubmed

32598019

Bibliographic record

Endokrynologia Polska 2020;71(4):306-312.

Keywords

FGF23
PTH
vitamin D
parathyroid adenoma
bone

Authors

Stefana Catalina Bilha
Alina Andreea Gatu
Cristian Velicescu
Andrei Bilha
Alexandru Florescu
Dumitru Branisteanu

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