The Role of Iron and Erythropoietin in the Association of Fibroblast Growth Factor 23 with Anemia in Chronic Kidney Disease in Humans
Anemia in chronic kidney disease (CKD) is an almost universal complication of this condition. Fibroblast growth factor 23 (FGF23), a key-player in mineral metabolism, is reportedly associated with anemia and hemoglobin levels in non-dialysis CKD patients. Here, we sought to further characterize this...
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Veröffentlicht in: | Journal of clinical medicine 2020-08, Vol.9 (8), p.2640 |
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description | Anemia in chronic kidney disease (CKD) is an almost universal complication of this condition. Fibroblast growth factor 23 (FGF23), a key-player in mineral metabolism, is reportedly associated with anemia and hemoglobin levels in non-dialysis CKD patients. Here, we sought to further characterize this association while taking into account the biologically active, intact fraction of FGF23, iron metabolism, and erythropoietin (EPO). Hemoglobin, EPO, iron, and mineral metabolism parameters, including both intact and c-terminal-FGF23 (iFGF23 and cFGF23, respectively) were measured cross-sectionally in 225 non-dialysis CKD patients (stage 1–5, median eGFR: 30 mL/min./1.73m2) not on erythropoiesis stimulating agents or intravenous iron therapy. Statistical analysis was performed by multiple linear regression. After adjustment for eGFR and other important confounders, only cFGF23 but not iFGF23 was significantly associated with hemoglobin levels and this association was largely accounted for by iron metabolism parameters. cFGF23 but not iFGF23 was also associated with mean corpuscular hemoglobin (MCH) and mean corpuscular volume (MCV), again in dependence on iron metabolism parameters. Similarly, EPO concentrations were associated with cFGF23 but not iFGF23, but their contribution to the association of cFGF23 with hemoglobin levels was marginal. In pre-dialysis CKD patients, the observed association of FGF23 with hemoglobin seems to be restricted to cFGF23 and largely explained by the iron status. |
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Fibroblast growth factor 23 (FGF23), a key-player in mineral metabolism, is reportedly associated with anemia and hemoglobin levels in non-dialysis CKD patients. Here, we sought to further characterize this association while taking into account the biologically active, intact fraction of FGF23, iron metabolism, and erythropoietin (EPO). Hemoglobin, EPO, iron, and mineral metabolism parameters, including both intact and c-terminal-FGF23 (iFGF23 and cFGF23, respectively) were measured cross-sectionally in 225 non-dialysis CKD patients (stage 1–5, median eGFR: 30 mL/min./1.73m2) not on erythropoiesis stimulating agents or intravenous iron therapy. Statistical analysis was performed by multiple linear regression. After adjustment for eGFR and other important confounders, only cFGF23 but not iFGF23 was significantly associated with hemoglobin levels and this association was largely accounted for by iron metabolism parameters. cFGF23 but not iFGF23 was also associated with mean corpuscular hemoglobin (MCH) and mean corpuscular volume (MCV), again in dependence on iron metabolism parameters. Similarly, EPO concentrations were associated with cFGF23 but not iFGF23, but their contribution to the association of cFGF23 with hemoglobin levels was marginal. In pre-dialysis CKD patients, the observed association of FGF23 with hemoglobin seems to be restricted to cFGF23 and largely explained by the iron status.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm9082640</identifier><identifier>PMID: 32823844</identifier><language>eng</language><publisher>Basel: MDPI AG</publisher><subject>Anemia ; Biomarkers ; Clinical medicine ; Cytokines ; Diabetes ; Fibroblasts ; Gene expression ; Growth factors ; Hemoglobin ; Homeostasis ; Hypoxia ; Immunoassay ; Inflammation ; Influence ; Iron ; Kidney diseases ; Laboratories ; Metabolism ; Proteins ; Variables</subject><ispartof>Journal of clinical medicine, 2020-08, Vol.9 (8), p.2640</ispartof><rights>2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). 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Fibroblast growth factor 23 (FGF23), a key-player in mineral metabolism, is reportedly associated with anemia and hemoglobin levels in non-dialysis CKD patients. Here, we sought to further characterize this association while taking into account the biologically active, intact fraction of FGF23, iron metabolism, and erythropoietin (EPO). Hemoglobin, EPO, iron, and mineral metabolism parameters, including both intact and c-terminal-FGF23 (iFGF23 and cFGF23, respectively) were measured cross-sectionally in 225 non-dialysis CKD patients (stage 1–5, median eGFR: 30 mL/min./1.73m2) not on erythropoiesis stimulating agents or intravenous iron therapy. Statistical analysis was performed by multiple linear regression. After adjustment for eGFR and other important confounders, only cFGF23 but not iFGF23 was significantly associated with hemoglobin levels and this association was largely accounted for by iron metabolism parameters. cFGF23 but not iFGF23 was also associated with mean corpuscular hemoglobin (MCH) and mean corpuscular volume (MCV), again in dependence on iron metabolism parameters. Similarly, EPO concentrations were associated with cFGF23 but not iFGF23, but their contribution to the association of cFGF23 with hemoglobin levels was marginal. In pre-dialysis CKD patients, the observed association of FGF23 with hemoglobin seems to be restricted to cFGF23 and largely explained by the iron status.</description><subject>Anemia</subject><subject>Biomarkers</subject><subject>Clinical medicine</subject><subject>Cytokines</subject><subject>Diabetes</subject><subject>Fibroblasts</subject><subject>Gene expression</subject><subject>Growth factors</subject><subject>Hemoglobin</subject><subject>Homeostasis</subject><subject>Hypoxia</subject><subject>Immunoassay</subject><subject>Inflammation</subject><subject>Influence</subject><subject>Iron</subject><subject>Kidney diseases</subject><subject>Laboratories</subject><subject>Metabolism</subject><subject>Proteins</subject><subject>Variables</subject><issn>2077-0383</issn><issn>2077-0383</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNpdkd1qXCEUhSW0JCHNTZ5A6E0pTOPf8eemMEwzSWigUJJr8Xi043COTtWTMA_Q965DQtNWNuhmf3vhYgFwgdEnShW63NpJIUk4Q0fglCAhFohK-uav9wk4L2WL2pGSESyOwQklklDJ2Cn4db9x8HsaHUwe3uYUoYkDvMr7uslpl4KrIcJWtWHLUpINpoZGNXod-pz60ZQKr3N6qhu4NramDAmFT6G1y-imYA7bqyYWg4VfwxDdHn4JxZniDpObeTKxvANvvRmLO3-5z8DD-up-dbO4-3Z9u1reLWzzUReYM9craoxng8WKcoUVcqzjlhLeS-G9VB71yFMqBSJkEFwJ67FRHTZOCHoGPj_r7uZ-coN1sWYz6l0Ok8l7nUzQ_05i2Ogf6VELxqkQqgl8eBHI6efsStVTKNaNo4kuzUUTRjlVjHS8oe__Q7dpzrHZ0y0tjDpOuq5RH58pm1Mp2fk_n8FIHwLWrwHT3ziTluU</recordid><startdate>20200814</startdate><enddate>20200814</enddate><creator>Bielesz, Bernhard</creator><creator>Reiter, Thomas</creator><creator>Hammerle, Fabian Peter</creator><creator>Winnicki, Wolfgang</creator><creator>Bojic, Marija</creator><creator>Gleiss, Andreas</creator><creator>Kieweg, Heidi</creator><creator>Ratzinger, Franz</creator><creator>Sunder-Plassmann, Gere</creator><creator>Marculescu, Rodrig</creator><general>MDPI AG</general><general>MDPI</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-7755-4445</orcidid><orcidid>https://orcid.org/0000-0002-0511-6120</orcidid><orcidid>https://orcid.org/0000-0003-1772-6695</orcidid><orcidid>https://orcid.org/0000-0002-9253-9921</orcidid><orcidid>https://orcid.org/0000-0001-9732-4439</orcidid></search><sort><creationdate>20200814</creationdate><title>The Role of Iron and Erythropoietin in the Association of Fibroblast Growth Factor 23 with Anemia in Chronic Kidney Disease in Humans</title><author>Bielesz, Bernhard ; 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Fibroblast growth factor 23 (FGF23), a key-player in mineral metabolism, is reportedly associated with anemia and hemoglobin levels in non-dialysis CKD patients. Here, we sought to further characterize this association while taking into account the biologically active, intact fraction of FGF23, iron metabolism, and erythropoietin (EPO). Hemoglobin, EPO, iron, and mineral metabolism parameters, including both intact and c-terminal-FGF23 (iFGF23 and cFGF23, respectively) were measured cross-sectionally in 225 non-dialysis CKD patients (stage 1–5, median eGFR: 30 mL/min./1.73m2) not on erythropoiesis stimulating agents or intravenous iron therapy. Statistical analysis was performed by multiple linear regression. After adjustment for eGFR and other important confounders, only cFGF23 but not iFGF23 was significantly associated with hemoglobin levels and this association was largely accounted for by iron metabolism parameters. cFGF23 but not iFGF23 was also associated with mean corpuscular hemoglobin (MCH) and mean corpuscular volume (MCV), again in dependence on iron metabolism parameters. Similarly, EPO concentrations were associated with cFGF23 but not iFGF23, but their contribution to the association of cFGF23 with hemoglobin levels was marginal. In pre-dialysis CKD patients, the observed association of FGF23 with hemoglobin seems to be restricted to cFGF23 and largely explained by the iron status.</abstract><cop>Basel</cop><pub>MDPI AG</pub><pmid>32823844</pmid><doi>10.3390/jcm9082640</doi><orcidid>https://orcid.org/0000-0002-7755-4445</orcidid><orcidid>https://orcid.org/0000-0002-0511-6120</orcidid><orcidid>https://orcid.org/0000-0003-1772-6695</orcidid><orcidid>https://orcid.org/0000-0002-9253-9921</orcidid><orcidid>https://orcid.org/0000-0001-9732-4439</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Anemia Biomarkers Clinical medicine Cytokines Diabetes Fibroblasts Gene expression Growth factors Hemoglobin Homeostasis Hypoxia Immunoassay Inflammation Influence Iron Kidney diseases Laboratories Metabolism Proteins Variables |
title | The Role of Iron and Erythropoietin in the Association of Fibroblast Growth Factor 23 with Anemia in Chronic Kidney Disease in Humans |
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