Evaluation of serum Fibroblast growth factor-23 in patients with beta-thalassemia major compared to healthy population

F. Saki, G. Ranjbar Omrani
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Abstract

Background: The role of phosphate hemostasis in development of thalassemia bone disease has not been extensively studied yet. Due to the lack of sufficient human studies about the changes of serum Fibroblast growth factor-23(FGF23) in patients with beta-thalassemia major as the first step of investigating the role of FGF23 in thalassemia bone disease, the present study aimed to investigate the serum level of FGF23 in patients with thalassemia major. Material and Method: In this case-control study, 25 patients with beta thalassemia major and their age- and sex-matched healthy volunteers were enrolled. Serum phosphorous, calcium, parathyroid hormone (PTH), 25(OH) D, erythropoietin (EPO), serum intact FGF23 (iFGF23) and 1,25 (OH)2 D were checked and analyzed. Result: Patients with beta-thalassemia major had lower 1,25 (OH)2D, (p = 0.025), higher phosphate (p = 0.002), and higher PTH (P <0.001) compared to the control group; however, all of them were in their normal blood range. They also had higher serum FGF23 (p = 0.007) and higher EPO (P<0.001). Serum FGF23 had an independent association with serum Iron (p=0.016), 1, 25(OH)2 Vitamin D (p<0.001), and hemoglobin (p=0.002). Conclusion: Serum FGF23 was associated with serum Iron, 1, 25(OH)2 Vitamin D, and hemoglobin in beta-thalassemia major patients. Hence, it seems that regular transfusions and chelating agents which can decrease the serum iron and increase hemoglobin level can be associated with lower iFGF23.
重度β -地中海贫血患者血清成纤维细胞生长因子-23与健康人群的比较
背景:磷酸盐止血在地中海贫血骨病发展中的作用尚未得到广泛研究。由于作为研究FGF23在地中海贫血骨病中的作用的第一步,β -地中海贫血患者血清成纤维细胞生长因子-23(Fibroblast growth factor-23, FGF23)的变化缺乏足够的人体研究,因此本研究旨在研究严重地中海贫血患者血清FGF23水平。材料和方法:在本病例对照研究中,纳入了25例重度地中海贫血患者及其年龄和性别匹配的健康志愿者。检测血清磷、钙、甲状旁腺激素(PTH)、25(OH) D、促红细胞生成素(EPO)、血清完整FGF23 (iFGF23)和1,25 (OH) 2d。结果:与对照组相比,重度地中海贫血患者血清1,25 (OH)2D (p = 0.025)、磷酸(p = 0.002)、甲状旁腺激素(PTH)升高(p <0.001);然而,他们都在正常的血液范围内。血清FGF23升高(p = 0.007), EPO升高(p <0.001)。血清FGF23与血清铁(p=0.016)、1,25 (OH)2维生素D (p<0.001)和血红蛋白(p=0.002)独立相关。结论:β -地中海贫血重症患者血清FGF23与血清铁、1,25 (OH)2维生素D和血红蛋白相关。因此,经常输血和螯合剂可以降低血清铁和增加血红蛋白水平,可能与降低iFGF23有关。
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