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01-11-2010

Circulating Fibroblast Growth Factor-23 Increases Following Intermittent Parathyroid Hormone (1–34) in Postmenopausal Osteoporosis: Association with Biomarker of Bone Formation

Authors: M. Sridharan, J. Cheung, A. E. Moore, M. L. Frost, W. D. Fraser, I. Fogelman, G. Hampson

Published in: Calcified Tissue International | Issue 5/2010

Abstract

Uncertainties exist regarding whether FGF-23 production is influenced by PTH and its involvement in bone formation. We evaluated FGF-23 response and its relation to changes in biomarkers of bone formation following intermittent PTH treatment. Twenty-seven women with a mean [SD] age of 75.8 [5.4] years with postmenopausal osteoporosis were treated with PTH(1–34) for 18 months. Bone mineral density (BMD) was measured at 6 and 18 months at the lumbar spine (LS) and total hip (TH). Blood samples were obtained at baseline, 1–3, 6–9, and 12–18 months. Serum calcium, phosphate, PTH, 25(OH)vitamin D, 1,25(OH)₂vitamin D, markers of bone turnover, FGF-23, and sclerostin were measured. BMD increased at both the LS (11.6%, P < 0.001) and TH (2.5%, P < 0.01). The bone formation marker P1NP increased early (baseline mean [SD] 39.9 [24.4] μg/l, 1–3 months 88 [37.9] μg/l; P < 0.001) and remained higher than baseline throughout 18 months. FGF-23 also increased, with a peak response at 6–9 months (increase 65%, P = 0.002). Serum phosphate remained stable. A significant increase in 1.25(OH)₂vitamin D (P = 0.02) was seen at 1–3 months only. A small but significant reduction in sclerostin was seen at 6–9 (P = 0.02) and 12–18 months (P = 0.06). There was a positive correlation between changes in P1NP and FGF-23 (6–9 months r = 0.78, P < 0.001). FGF-23 is increased by intermittent PTH(1–34). This is related to early changes in P1NP, suggesting that the skeletal effects of PTH may involve FGF-23. Further studies are required to elucidate this.

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Title: Circulating Fibroblast Growth Factor-23 Increases Following Intermittent Parathyroid Hormone (1–34) in Postmenopausal Osteoporosis: Association with Biomarker of Bone Formation
Authors: M. Sridharan
J. Cheung
A. E. Moore
M. L. Frost
W. D. Fraser
I. Fogelman
G. Hampson
Publication date: 01-11-2010
Publisher: Springer-Verlag
Published in: Calcified Tissue International / Issue 5/2010
Print ISSN: 0171-967X
Electronic ISSN: 1432-0827
DOI: https://doi.org/10.1007/s00223-010-9414-8

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