title: Lower fibroblast growth factor 23 levels in young adults with Crohn disease as a possible secondary compensatory effect on the disturbance of bone and mineral metabolism.
abstract: Fibroblast growth factor 23 (FGF-23) is a bone-derived circulating phosphaturic factor that decreases serum concentration of phosphate and vitamin D, suggested to actively participate in a complex renal-gastrointestinal-skeletal axis. Serum FGF-23 concentrations, as well as various other laboratory parameters involved in bone homeostasis, were measured and analyzed with regard to various diseases and patients' characteristics in 44 patients with Crohn disease (CD) and 20 healthy controls (HCs) included in this cross-sectional study. Serum FGF-23 levels were significantly lower in patients with CD (900.42 ± 815.85pg/mL) compared with HC (1410.94 ± 1000.53pg/mL), p = 0.037. Further analyses suggested FGF-23 as a factor independent from various parameters including age (r = -0.218), body mass index (r = -0.115), 25-hydroxy vitamin D (r = 0.126), parathyroid hormone (r = 0.084), and bone mineral density (BMD) of hip and lumbar (r = 0.205 and r = 0.149, respectively). This observation remained even after multivariate analyses, exhibiting that BMD was not affected by FGF-23, although parameters such as age (p = 0.026), cumulative prednisolone dose (p < 0.0001), and smoking status (p = 0.024) were strong determinants of BMD regarding hip. Lower FGF-23 levels in patients with bowel inflammation are accompanied but not directly correlated with lower vitamin D levels, showing no impact on BMD determination of young adults with CD. The downregulation of serum FGF-23 levels in CD appears as a secondary compensatory effect on the bone and mineral metabolism induced by chronic intestinal inflammation.
authors.affiliation: Department of Gastroenterology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece; Institute for Biomedical Research & Technology (BIOMED), Centre for Research and Technology-Thessaly (CERETETH), Larissa, Greece.
authors.forename: Konstantinos A
authors.initials: KA
authors.lastname: Oikonomou
authors.affiliation: Institute for Biomedical Research & Technology (BIOMED), Centre for Research and Technology-Thessaly (CERETETH), Larissa, Greece.
authors.forename: Timoklia I
authors.initials: TI
authors.lastname: Orfanidou
authors.affiliation: Department of Radiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece. Electronic address: mvlychou@med.uth.gr.
authors.forename: Marianna K
authors.initials: MK
authors.lastname: Vlychou
authors.affiliation: Department of Gastroenterology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
authors.forename: Andreas N
authors.initials: AN
authors.lastname: Kapsoritakis
authors.affiliation: Institute for Biomedical Research & Technology (BIOMED), Centre for Research and Technology-Thessaly (CERETETH), Larissa, Greece; Department of Biology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
authors.forename: Aspasia
authors.initials: A
authors.lastname: Tsezou
authors.affiliation: Institute for Biomedical Research & Technology (BIOMED), Centre for Research and Technology-Thessaly (CERETETH), Larissa, Greece; Department of Orthopaedics, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
authors.forename: Konstantinos N
authors.initials: KN
authors.lastname: Malizos
authors.affiliation: Department of Gastroenterology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
authors.forename: Spyros P
authors.initials: SP
authors.lastname: Potamianos
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D015519:Bone Density / Q000502:physiology*; D002113:Calcification, Physiologic / Q000502:physiology*; D016022:Case-Control Studies; D003424:Crohn Disease / Q000097:blood*; D003430:Cross-Sectional Studies; D005260:Female; D005269:Femur; D000089703:Fibroblast Growth Factor-23; D005346:Fibroblast Growth Factors / Q000097:blood*; D006801:Humans; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D055815:Young Adult
chemical_list: C000717427:FGF23 protein, human; D014807:Vitamin D; D005346:Fibroblast Growth Factors; D000089703:Fibroblast Growth Factor-23; C104450:25-hydroxyvitamin D
keywords: 25-hydroxy vitamin D (25OHD); Bone homeostasis; Crohn disease (CD); bone mineral density (BMD); fibroblast growth factor 23 (FGF-23)