Serum Calcium as a Determinant of Fibroblast Growth Factor 23 Levels in Patients With Primary Hyperparathyroidism and Graves' Disease.

IF 1.3 Q3 MEDICINE, GENERAL & INTERNAL

Cureus Pub Date : 2025-10-06 eCollection Date: 2025-10-01 DOI:10.7759/cureus.93972

Hiroyuki Yamashita, Yusuke Mori, Yasuo Imanishi, Hisakazu Shindo, Daisuke Tatsushima, Seigo Tachibana, Takashi Fukuda, Hiroshi Takahashi, Yuji Nagayama, Shinya Satoh

{"title":"Serum Calcium as a Determinant of Fibroblast Growth Factor 23 Levels in Patients With Primary Hyperparathyroidism and Graves' Disease.","authors":"Hiroyuki Yamashita, Yusuke Mori, Yasuo Imanishi, Hisakazu Shindo, Daisuke Tatsushima, Seigo Tachibana, Takashi Fukuda, Hiroshi Takahashi, Yuji Nagayama, Shinya Satoh","doi":"10.7759/cureus.93972","DOIUrl":null,"url":null,"abstract":"Objective: Fibroblast growth factor 23 (FGF23) is a phosphate-regulating hormone with an emerging role in calcium homeostasis. However, its role in hypercalcemic conditions remains unclear. This study aimed to investigate the relationship between serum calcium and FGF23 levels in two hypercalcemic disorders: primary hyperparathyroidism (PHPT) and Graves' disease.Methods: A cross-sectional analysis was performed in 98 patients with PHPT and 45 patients with Graves' disease. Clinical and biochemical parameters, including parathyroid hormone (PTH), phosphate, and 1,25-dihydroxyvitamin D3 (1,25(OH)2D), were analyzed.Results: In PHPT, serum calcium was the only independent determinant of FGF23 levels (P < 0.0001), whereas in Graves' disease, both serum calcium (P < 0.001) and 1,25(OH)2D (P < 0.005) were independently associated with FGF23. A significant positive correlation between calcium and FGF23 was observed in both conditions. Interestingly, FGF23 levels were elevated despite different phosphate profiles: hypophosphatemia in PHPT and hyperphosphatemia in Graves' disease.Conclusions: These findings suggest that hypercalcemia may directly contribute to FGF23 elevation, independent of phosphate levels. However, the compensatory effect of FGF23 in modulating calcium homeostasis appears to be limited. This study provides new insights into the calcium sensitivity of FGF23 in endocrine disorders characterized by altered mineral metabolism.","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 10","pages":"e93972"},"PeriodicalIF":1.3000,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12500342/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cureus","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.7759/cureus.93972","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/10/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: Fibroblast growth factor 23 (FGF23) is a phosphate-regulating hormone with an emerging role in calcium homeostasis. However, its role in hypercalcemic conditions remains unclear. This study aimed to investigate the relationship between serum calcium and FGF23 levels in two hypercalcemic disorders: primary hyperparathyroidism (PHPT) and Graves' disease.

Methods: A cross-sectional analysis was performed in 98 patients with PHPT and 45 patients with Graves' disease. Clinical and biochemical parameters, including parathyroid hormone (PTH), phosphate, and 1,25-dihydroxyvitamin D3 (1,25(OH)₂D), were analyzed.

Results: In PHPT, serum calcium was the only independent determinant of FGF23 levels (P < 0.0001), whereas in Graves' disease, both serum calcium (P < 0.001) and 1,25(OH)₂D (P < 0.005) were independently associated with FGF23. A significant positive correlation between calcium and FGF23 was observed in both conditions. Interestingly, FGF23 levels were elevated despite different phosphate profiles: hypophosphatemia in PHPT and hyperphosphatemia in Graves' disease.

Conclusions: These findings suggest that hypercalcemia may directly contribute to FGF23 elevation, independent of phosphate levels. However, the compensatory effect of FGF23 in modulating calcium homeostasis appears to be limited. This study provides new insights into the calcium sensitivity of FGF23 in endocrine disorders characterized by altered mineral metabolism.

Abstract Image

查看原文本刊更多论文

原发性甲状旁腺功能亢进和Graves病患者血清钙对成纤维细胞生长因子23水平的影响

目的：成纤维细胞生长因子23 （FGF23）是一种磷酸盐调节激素，在钙稳态中起着新的作用。然而，其在高钙血症中的作用尚不清楚。本研究旨在探讨原发性甲状旁腺功能亢进（PHPT）和Graves病两种高钙血症患者血清钙和FGF23水平之间的关系。方法：对98例PHPT患者和45例Graves病患者进行横断面分析。分析临床及生化指标，包括甲状旁腺激素（PTH）、磷酸、1,25-二羟基维生素D3 （1,25(OH)2D）。结果：在PHPT中，血清钙是FGF23水平的唯一独立决定因素（P < 0.0001），而在Graves病中，血清钙（P < 0.001）和1,25(OH)2D （P < 0.005）与FGF23水平独立相关。在两种情况下，钙和FGF23之间均观察到显著的正相关。有趣的是，尽管存在不同的磷酸盐谱，但FGF23水平升高：PHPT的低磷血症和Graves病的高磷血症。结论：这些发现表明，高钙血症可能直接导致FGF23升高，而不依赖于磷酸盐水平。然而，FGF23在调节钙稳态中的补偿作用似乎是有限的。本研究为FGF23在以矿物质代谢改变为特征的内分泌紊乱中的钙敏感性提供了新的见解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Cureus

自引率

0.00%

发文量