Assessment of arterial stiffness and plasma FGF23 levels in patients with hypoparathyroidism

IF 1.8 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Endocrinologia Diabetes Y Nutricion Pub Date : 2026-04-01 Epub Date: 2026-04-21 DOI:10.1016/j.endien.2026.501724

Irene Berges-Raso , Ismael Capel , Albert Cano , Rocío Pareja , Jaume Almirall , Ruth Cano , Assumpta Caixàs , Mercedes Rigla

{"title":"Assessment of arterial stiffness and plasma FGF23 levels in patients with hypoparathyroidism","authors":"Irene Berges-Raso , Ismael Capel , Albert Cano , Rocío Pareja , Jaume Almirall , Ruth Cano , Assumpta Caixàs , Mercedes Rigla","doi":"10.1016/j.endien.2026.501724","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Patients with hypoparathyroidism are at a higher cardiovascular risk (CVR) due to mechanisms that are not yet well understood. In patients with renal failure, fibroblast growth factor 23 (FGF23) has been associated with an increased calcification and arterial stiffness (AS), leading to an increased CVR. In hypoparathyroidism—due to the situation of hyperphosphatemia—an increase in FGF23 is also probable. There is a paucity of research examining the relationship between FGF23 levels and AS in patients with hypoparathyroidism. The present study aims to assess AS, by measuring aortic pulse wave velocity (aPWV), and FGF23 levels in patients with hypoparathyroidism vs age and sex matched healthy controls.</div></div><div><h3>Material and methods</h3><div>We conducted a cross-sectional descriptive study, and collected demographical data of patients and treatment characteristics (calcium and vitamin D doses). Furthermore, we measured aPWV using the SphygmoCorXCEL® device and assessed FGF23 and all other parameters of calcium–phosphorus metabolism in a blood and 24h-urine samples.</div></div><div><h3>Results and discussion</h3><div>A total of 20 subjects with hypoparathyroidism (85% postoperative) and 16 healthy matched controls were included. The mean age was 58.6 years (SD, 12.2). The mean course of the disease was 16.31 years (3–44). Regarding the general characteristics, the most remarkable finding was that patients had an estimated glomerular filtration rate (eGFR) significantly lower than controls (72.5 [SD, 21.25] vs 95.3 [SD, 12.21]ml/min/1.73m<sup>2</sup>; <em>p</em>   <0.05). A trend toward higher AS was observed in subjects with hypoparathyroidism (aPWV 8.4 [5.2–17.3] vs 6.9 [5.1–10.8]m/s; <em>p</em>  =0.679; <em>p</em>  <0.05). We found no significant correlation between aPWV and FGF23 or with phosphate levels or calcium supplements or calcitriol doses used in replacement treatment.</div></div><div><h3>Conclusions</h3><div>In subjects with hypoparathyroidism there is a marked increase in FGF23 levels and a trend toward a higher AS, which correlates with disease duration. However, these findings may be conditioned by an impaired renal function that this pathological process entails. A causal relationship could not be established between the elevated levels of FGF23 and AS.</div></div>","PeriodicalId":48650,"journal":{"name":"Endocrinologia Diabetes Y Nutricion","volume":"73 4","pages":"Article 501724"},"PeriodicalIF":1.8000,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Endocrinologia Diabetes Y Nutricion","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2530018026000624","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/4/21 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction

Patients with hypoparathyroidism are at a higher cardiovascular risk (CVR) due to mechanisms that are not yet well understood. In patients with renal failure, fibroblast growth factor 23 (FGF23) has been associated with an increased calcification and arterial stiffness (AS), leading to an increased CVR. In hypoparathyroidism—due to the situation of hyperphosphatemia—an increase in FGF23 is also probable. There is a paucity of research examining the relationship between FGF23 levels and AS in patients with hypoparathyroidism. The present study aims to assess AS, by measuring aortic pulse wave velocity (aPWV), and FGF23 levels in patients with hypoparathyroidism vs age and sex matched healthy controls.

Material and methods

We conducted a cross-sectional descriptive study, and collected demographical data of patients and treatment characteristics (calcium and vitamin D doses). Furthermore, we measured aPWV using the SphygmoCorXCEL® device and assessed FGF23 and all other parameters of calcium–phosphorus metabolism in a blood and 24 h-urine samples.

Results and discussion

A total of 20 subjects with hypoparathyroidism (85% postoperative) and 16 healthy matched controls were included. The mean age was 58.6 years (SD, 12.2). The mean course of the disease was 16.31 years (3–44). Regarding the general characteristics, the most remarkable finding was that patients had an estimated glomerular filtration rate (eGFR) significantly lower than controls (72.5 [SD, 21.25] vs 95.3 [SD, 12.21] ml/min/1.73 m²; p < 0.001). FGF23 levels were clearly elevated in subjects with hypoparathyroidism (255.2 [35.9–1487.4] vs 61.9 [27.8–134.8] RU/mL; p < 0.05). A trend toward higher AS was observed in subjects with hypoparathyroidism (aPWV 8.4 [5.2–17.3] vs 6.9 [5.1–10.8] m/s; p = 0.08), as well as a positive correlation between aPWV and time of disease progression (r = 0.679; p < 0.01). A negative correlation was observed in subjects with hypoparathyroidism between aPWV and eGFR (−0.519; p < 0.05). We found no significant correlation between aPWV and FGF23 or with phosphate levels or calcium supplements or calcitriol doses used in replacement treatment.

Conclusions

In subjects with hypoparathyroidism there is a marked increase in FGF23 levels and a trend toward a higher AS, which correlates with disease duration. However, these findings may be conditioned by an impaired renal function that this pathological process entails. A causal relationship could not be established between the elevated levels of FGF23 and AS.

查看原文本刊更多论文

甲状旁腺功能减退患者动脉僵硬度和血浆FGF23水平的评估

甲状旁腺功能低下患者由于其机制尚不清楚而具有较高的心血管风险（CVR）。在肾功能衰竭患者中，成纤维细胞生长因子23 （FGF23）与钙化和动脉僵硬（AS）增加相关，导致CVR增加。在甲状旁腺功能减退症中，由于高磷血症的情况，FGF23也可能增加。关于甲状旁腺功能减退患者FGF23水平与AS之间关系的研究缺乏。本研究旨在通过测量甲状旁腺功能减退患者与年龄和性别匹配的健康对照组的主动脉脉冲波速度（aPWV）和FGF23水平来评估AS。材料和方法我们进行了一项横断面描述性研究，收集了患者的人口学数据和治疗特征（钙和维生素D剂量）。此外，我们使用SphygmoCorXCEL®设备测量aPWV，并评估血液和24 h-尿液样本中的FGF23和所有其他钙磷代谢参数。结果和讨论共纳入20例甲状旁腺功能减退患者（术后85%）和16例健康匹配对照。平均年龄58.6岁（SD, 12.2）。平均病程16.31年（3-44岁）。关于一般特征，最显著的发现是患者估计的肾小球滤过率（eGFR）显著低于对照组（72.5 [SD, 21.25] vs 95.3 [SD, 12.21] ml/min/1.73 m2; p < 0.001）。甲状旁腺功能减退患者FGF23水平明显升高（255.2 [35.9-1487.4]vs 61.9 [27.8-134.8] RU/mL; p < 0.05）。甲状旁腺功能减退患者有较高的AS趋势（aPWV 8.4 [5.2-17.3] vs 6.9 [5.1-10.8] m/s; p = 0.08）， aPWV与疾病进展时间呈正相关（r = 0.679; p < 0.01）。甲状旁腺功能减退患者aPWV与eGFR呈负相关（- 0.519;p < 0.05）。我们发现aPWV与FGF23或与磷酸盐水平、钙补充剂或骨化三醇替代治疗剂量之间无显著相关性。结论甲状旁腺功能减退患者FGF23水平明显升高，且有升高趋势，且与病程有关。然而，这些发现可能是由于肾脏功能受损，这一病理过程所必需的。FGF23水平升高与AS之间没有因果关系。

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

Endocrinologia Diabetes Y Nutricion Multiple-

CiteScore

2.10

自引率

10.50%

发文量

期刊介绍： Endocrinología, Diabetes y Nutrición is the official journal of the Spanish Society of Endocrinology and Nutrition (Sociedad Española de Endocrinología y Nutrición, SEEN) and the Spanish Society of Diabetes (Sociedad Española de Diabetes, SED), and was founded in 1954. The aim of the journal is to improve knowledge and be a useful tool in practice for clinical and laboratory specialists, trainee physicians, researchers, and nurses interested in endocrinology, diabetes, nutrition and related disciplines. It is an international journal published in Spanish (print and online) and English (online), covering different fields of endocrinology and metabolism, including diabetes, obesity, and nutrition disorders, as well as the most relevant research produced mainly in Spanish language territories. The quality of the contents is ensured by a prestigious national and international board, and by a selected panel of specialists involved in a rigorous peer review. The result is that only manuscripts containing high quality research and with utmost interest for clinicians and professionals related in the field are published. The Journal publishes Original clinical and research articles, Reviews, Special articles, Clinical Guidelines, Position Statements from both societies and Letters to the editor. Endocrinología, Diabetes y Nutrición can be found at Science Citation Index Expanded, Medline/PubMed and SCOPUS.