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...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Journal of clinical medicine 2020-08, Vol.9 (8), p.2640
Hauptverfasser: Bielesz, Bernhard, Reiter, Thomas, Hammerle, Fabian Peter, Winnicki, Wolfgang, Bojic, Marija, Gleiss, Andreas, Kieweg, Heidi, Ratzinger, Franz, Sunder-Plassmann, Gere, Marculescu, Rodrig
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page
container_issue 8
container_start_page 2640
container_title Journal of clinical medicine
container_volume 9
creator Bielesz, Bernhard
Reiter, Thomas
Hammerle, Fabian Peter
Winnicki, Wolfgang
Bojic, Marija
Gleiss, Andreas
Kieweg, Heidi
Ratzinger, Franz
Sunder-Plassmann, Gere
Marculescu, Rodrig
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.
doi_str_mv 10.3390/jcm9082640
format Article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7463779</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2436394256</sourcerecordid><originalsourceid>FETCH-LOGICAL-c383t-164eb93aaf4dc19369190e456c326b87ff89f0b0f3387022d7697cf1a951ae773</originalsourceid><addsrcrecordid>eNpdkd1qXCEUhSW0JCHNTZ5A6E0pTOPf8eemMEwzSWigUJJr8Xi043COTtWTMA_Q965DQtNWNuhmf3vhYgFwgdEnShW63NpJIUk4Q0fglCAhFohK-uav9wk4L2WL2pGSESyOwQklklDJ2Cn4db9x8HsaHUwe3uYUoYkDvMr7uslpl4KrIcJWtWHLUpINpoZGNXod-pz60ZQKr3N6qhu4NramDAmFT6G1y-imYA7bqyYWg4VfwxDdHn4JxZniDpObeTKxvANvvRmLO3-5z8DD-up-dbO4-3Z9u1reLWzzUReYM9craoxng8WKcoUVcqzjlhLeS-G9VB71yFMqBSJkEFwJ67FRHTZOCHoGPj_r7uZ-coN1sWYz6l0Ok8l7nUzQ_05i2Ogf6VELxqkQqgl8eBHI6efsStVTKNaNo4kuzUUTRjlVjHS8oe__Q7dpzrHZ0y0tjDpOuq5RH58pm1Mp2fk_n8FIHwLWrwHT3ziTluU</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2641056255</pqid></control><display><type>article</type><title>The Role of Iron and Erythropoietin in the Association of Fibroblast Growth Factor 23 with Anemia in Chronic Kidney Disease in Humans</title><source>PubMed Central Open Access</source><source>MDPI - Multidisciplinary Digital Publishing Institute</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><creator>Bielesz, Bernhard ; Reiter, Thomas ; Hammerle, Fabian Peter ; Winnicki, Wolfgang ; Bojic, Marija ; Gleiss, Andreas ; Kieweg, Heidi ; Ratzinger, Franz ; Sunder-Plassmann, Gere ; Marculescu, Rodrig</creator><creatorcontrib>Bielesz, Bernhard ; Reiter, Thomas ; Hammerle, Fabian Peter ; Winnicki, Wolfgang ; Bojic, Marija ; Gleiss, Andreas ; Kieweg, Heidi ; Ratzinger, Franz ; Sunder-Plassmann, Gere ; Marculescu, Rodrig</creatorcontrib><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.</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/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 by the authors. 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c383t-164eb93aaf4dc19369190e456c326b87ff89f0b0f3387022d7697cf1a951ae773</citedby><cites>FETCH-LOGICAL-c383t-164eb93aaf4dc19369190e456c326b87ff89f0b0f3387022d7697cf1a951ae773</cites><orcidid>0000-0002-7755-4445 ; 0000-0002-0511-6120 ; 0000-0003-1772-6695 ; 0000-0002-9253-9921 ; 0000-0001-9732-4439</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7463779/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7463779/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,882,27905,27906,53772,53774</link.rule.ids></links><search><creatorcontrib>Bielesz, Bernhard</creatorcontrib><creatorcontrib>Reiter, Thomas</creatorcontrib><creatorcontrib>Hammerle, Fabian Peter</creatorcontrib><creatorcontrib>Winnicki, Wolfgang</creatorcontrib><creatorcontrib>Bojic, Marija</creatorcontrib><creatorcontrib>Gleiss, Andreas</creatorcontrib><creatorcontrib>Kieweg, Heidi</creatorcontrib><creatorcontrib>Ratzinger, Franz</creatorcontrib><creatorcontrib>Sunder-Plassmann, Gere</creatorcontrib><creatorcontrib>Marculescu, Rodrig</creatorcontrib><title>The Role of Iron and Erythropoietin in the Association of Fibroblast Growth Factor 23 with Anemia in Chronic Kidney Disease in Humans</title><title>Journal of clinical medicine</title><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.</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 ; Reiter, Thomas ; Hammerle, Fabian Peter ; Winnicki, Wolfgang ; Bojic, Marija ; Gleiss, Andreas ; Kieweg, Heidi ; Ratzinger, Franz ; Sunder-Plassmann, Gere ; Marculescu, Rodrig</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c383t-164eb93aaf4dc19369190e456c326b87ff89f0b0f3387022d7697cf1a951ae773</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Anemia</topic><topic>Biomarkers</topic><topic>Clinical medicine</topic><topic>Cytokines</topic><topic>Diabetes</topic><topic>Fibroblasts</topic><topic>Gene expression</topic><topic>Growth factors</topic><topic>Hemoglobin</topic><topic>Homeostasis</topic><topic>Hypoxia</topic><topic>Immunoassay</topic><topic>Inflammation</topic><topic>Influence</topic><topic>Iron</topic><topic>Kidney diseases</topic><topic>Laboratories</topic><topic>Metabolism</topic><topic>Proteins</topic><topic>Variables</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bielesz, Bernhard</creatorcontrib><creatorcontrib>Reiter, Thomas</creatorcontrib><creatorcontrib>Hammerle, Fabian Peter</creatorcontrib><creatorcontrib>Winnicki, Wolfgang</creatorcontrib><creatorcontrib>Bojic, Marija</creatorcontrib><creatorcontrib>Gleiss, Andreas</creatorcontrib><creatorcontrib>Kieweg, Heidi</creatorcontrib><creatorcontrib>Ratzinger, Franz</creatorcontrib><creatorcontrib>Sunder-Plassmann, Gere</creatorcontrib><creatorcontrib>Marculescu, Rodrig</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of clinical medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bielesz, Bernhard</au><au>Reiter, Thomas</au><au>Hammerle, Fabian Peter</au><au>Winnicki, Wolfgang</au><au>Bojic, Marija</au><au>Gleiss, Andreas</au><au>Kieweg, Heidi</au><au>Ratzinger, Franz</au><au>Sunder-Plassmann, Gere</au><au>Marculescu, Rodrig</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Role of Iron and Erythropoietin in the Association of Fibroblast Growth Factor 23 with Anemia in Chronic Kidney Disease in Humans</atitle><jtitle>Journal of clinical medicine</jtitle><date>2020-08-14</date><risdate>2020</risdate><volume>9</volume><issue>8</issue><spage>2640</spage><pages>2640-</pages><issn>2077-0383</issn><eissn>2077-0383</eissn><abstract>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.</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>
fulltext fulltext
identifier ISSN: 2077-0383
ispartof Journal of clinical medicine, 2020-08, Vol.9 (8), p.2640
issn 2077-0383
2077-0383
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7463779
source PubMed Central Open Access; MDPI - Multidisciplinary Digital Publishing Institute; EZB-FREE-00999 freely available EZB journals; PubMed Central
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
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-20T22%3A52%3A00IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20Role%20of%20Iron%20and%20Erythropoietin%20in%20the%20Association%20of%20Fibroblast%20Growth%20Factor%2023%20with%20Anemia%20in%20Chronic%20Kidney%20Disease%20in%20Humans&rft.jtitle=Journal%20of%20clinical%20medicine&rft.au=Bielesz,%20Bernhard&rft.date=2020-08-14&rft.volume=9&rft.issue=8&rft.spage=2640&rft.pages=2640-&rft.issn=2077-0383&rft.eissn=2077-0383&rft_id=info:doi/10.3390/jcm9082640&rft_dat=%3Cproquest_pubme%3E2436394256%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2641056255&rft_id=info:pmid/32823844&rfr_iscdi=true