FGF-23 als Knochenmarker bei metabolischen Osteopathien

2020 ◽  
Vol 29 (01) ◽  
pp. 21-30
Author(s):  
Oliver Dietrich ◽  
Rainer Danneberg ◽  
Juliane Böttcher-Lorenz ◽  
Maik Keil ◽  
Peter M. Jehle
Keyword(s):  
Vitamin D3 ◽  
Alkalische Phosphatase ◽  
Trap 5B ◽  
Fgf 23

ZusammenfassungDie Osteoporose ist die führende metabolische Knochenerkrankung des höheren Lebensalters. In den aktuellen Leitlinien des DVO spielen klinische Risikofaktoren ein zunehmend größere Rolle, sowohl im Hinblick auf die Diagnostik als auch auf die Therapie der verschiedenen Formen der Osteoporose. Neben verschiedenen Ko-Morbiditäten weisen diese Patienten häufig eine Einschränkung der Nierenfunktion auf.Die Entdeckung des phosphatsenkenden Hormons FGF-23 und das zunehmende Verständnis zu dessen Rolle im Calcium-Phosphat Stoffwechsel eröffnen neue Einblicke in das Verständnis der komplexen pathophysiologischen Vorgänge metabolischer Osteopathien. FGF-23 wird im Knochen bei ansteigenden Phosphatspiegeln vermehrt gebildet. An der Niere wirkt FGF-23 phosphaturisch. Durch ansteigende FGF-23-Spiegel gelingt es auch bei nachlassender Nierenfunktion, möglichst lange ein Ansteigen des Serumphosphats zu vermeiden. In einer Vielzahl von Studien konnten signifikante Korrelationen zwischen FGF-23-Spiegeln, Phosphatwerten und der kardiovaskulären Mortalität von Patienten mit und ohne Niereninsuffizienz aufgezeigt werden. Studien zur Rolle von FGF-23 im Knochenstoffwechsel liegen bislang nur vereinzelt vor.Ziel der durchgeführten Untersuchung war es, bei Patienten mit Osteoporose und noch weitestgehend erhaltener Nierenfunktion die mögliche diagnostische Bedeutung von FGF-23 im Vergleich zu etablierten Knochenmarkern wie Knochenspezifische alkalische Phosphatase (BAP) und der Tartrat-resistenten sauren Phosphatase Isoform 5b (TRAP-5b) zu betrachten.In einer prospektiven Pilotstudie wurden 55 Patienten mit metabolischen Osteopathien (überwiegend Osteoporose) aus der endokrinologischen Ermächtigungssprechstunde von Prof. Dr. Jehle untersucht. Neben den klinischen Daten und den routinemäßig bestimmten Laborparametern (Calcium, Phosphat, Kreatinin, eGFR, PTH, 25-OH-Vitamin D3, BAP, TRAP-5b) wurde FGF-23 einmalig mit einem spezifischen ELISA gemessen. Zusammenfassend kann gesagt werden, dass die Daten der Pilotstudie zeigen, dass FGF-23 für einzelne Patienten von diagnostischer Relevanz sein kann. Insbesondere erniedrigte Phosphatspiegel können durch die Messung von FGF-23 besser eingeordnet werden. Die weitere Erforschung von FGF-23 und dessen Rolle beim Knochenstoffwechsel scheint vielversprechend.

scholarly journals Association between shift work and biological factors including FGF-23, klotho, and serum 25-(OH) vitamin D3 among Korean firefighters: a cross-sectional study

SLEEP ◽  
2020 ◽  
Vol 43 (10) ◽  
Author(s):  
Jeehee Min ◽  
Tae-Won Jang ◽  
Yeon Soon Ahn ◽  
Chang Sun Sim ◽  
Kyoung Sook Jeong
Keyword(s):  
Shift Work ◽  
Cancer Progression ◽  
Vitamin D3 ◽  
Serum Vitamin ◽  
Cross Sectional Study ◽  
Health Habits ◽  
Cross Sectional ◽  
Shift Workers ◽  
Potential Risk Factors ◽  
Fgf 23

Abstract Study Objectives Shift work is known to be detrimental to an individual’s health as it disrupts the circadian rhythm and is a risk factor for cancer. It has been reported that elevated fibroblast growth factor (FGF)-23, increased serum soluble α-klotho, and decreased vitamin D3 are associated with cancer progression. We studied the relationship between shift work and the levels of FGF-23, α-klotho, and vitamin D3 amongst firefighters, as they work in long shifts outside the traditional daytime schedule. Methods The study consisted of 450 participants who were firefighters. We measured FGF-23, α-klotho, and vitamin D3 levels in their blood and a set of questionnaires were given to the participants to evaluate their health habits. After determining and adjusting for potential confounding factors, we compared the levels of FGF-23, α-klotho, and serum vitamin D3 by job and shift types. Results FGF-23 and α-klotho levels were significantly higher in shift workers than traditional day workers, and in 3-day cycle shift workers than workers with another shift schedule. When the levels of these substances were compared based on different types of jobs, firefighters had a lower level of vitamin D3. We conclude that shift work is positively correlated with the levels of FGF-23 and α-klotho. Conclusions Levels of FGF-23 and α-klotho were linked to shift work and job types. Although vitamin levels did not differ by shift types, vitamin D3 levels were lower in firefighters. These findings suggest that high levels of FGF-23 and α-klotho are potential risk factors for cancer among firefighters.

scholarly journals BIOCHEMICAL MARKERS OF BONE RESORPTION, REGULATION OF OSTEOCLASTOGENESIS AND BONE LOSS FOLLOWING LIVER TRANSPLANTATION

2013 ◽  
Vol 16 (1) ◽  
pp. 18-23
Author(s):  
V P Buzulina ◽  
I A Pronchenko ◽  
I P Ermakova ◽  
N P Shmerko ◽  
A A Andrianova ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Bone Density ◽  
Bone Resorption ◽  
Vitamin D3 ◽  
Tartrate Resistant Acid Phosphatase ◽  
Specific Marker ◽  
Neck Of Femur ◽  
Early Date ◽  
Trap 5B ◽  
Markers Of Bone Resorption

Methods and results: bone densitometry of L2-L4 and neck of femur, the level in serum of blood some hormones (PTH, vitamin D3, estradiol, testosterone) and cytokines (OPG, IL-6, FNO-a) regulating osteoclastogenesis as well as comparative analyses of two bone resorption markers β-crosslaps and tartrate-resistant acid phosphatase type 5b (TRAP-5b) were fulfilled at different periods following orthotopic liver transplantation. At the early date after operation there were the bone density decrease of L2-L4, the lowering of vitamin D3, estradiol in women, testosterone in men and the elevation of cytokines and of resorption markers. In 1 and 2 years following liver transplantation there were revealed the rise of bone density, the level of PTH, estradiol, testosterone, which were associated with the lowering of IL-6, FNO-a and β-crosslaps while the level of vitamin D3 and TRAP-5b remained stable. Conclusion: at the early date TRAP-5b was more specific marker of bone resorption which did not depend on collagen metabolism in liver. In 1 and 2 years following liver transplantation bone resorbtion was association with level of PTH, FNO-a and OPG.

scholarly journals Effect of Vitamin D-Enriched Gouda-Type Cheese Consumption on Biochemical Markers of Bone Metabolism in Postmenopausal Women in Greece

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 2985
Author(s):  
George Moschonis ◽  
Ellen GHM van den Heuvel ◽  
Christina Mavrogianni ◽  
Yannis Manios
Keyword(s):  
Vitamin D ◽  
Bone Resorption ◽  
Bone Metabolism ◽  
Postmenopausal Women ◽  
Vitamin D3 ◽  
Daily Intake ◽  
Intervention Group ◽  
Serum Concentrations ◽  
Early Postmenopausal Women ◽  
Trap 5B

Considering the role of bone metabolism in understanding the pathogenesis of osteoporosis, the aim of the present study was to examine the effects of vitamin D-enriched cheese on the serum concentrations of the parathyroid hormone (PTH) and certain bone remodeling biomarkers in postmenopausal women in Greece. In a randomised, controlled dietary intervention, 79 postmenopausal women (55–75 years old) were randomly allocated either to a control (CG: n = 39) or an intervention group (IG: n = 40), consuming 60 g of either non-enriched or vitamin D3-enriched Gouda-type cheese (5.7 μg of vitamin D3), respectively, daily and for eight weeks during the winter. The serum concentrations of 25-hydroxy vitamin D (25(OH)D), PTH, bone formation (i.e., osteocalcin, P1NP) and bone resorption (i.e., TRAP-5b) biomarkers were measured. Consumption of the vitamin D-enriched cheese led to higher serum 25(OH)D concentrations of 23.4 ± 6.39 (p = 0.022) and 13.4 ± 1.35 (p < 0.001) nmol/L in vitamin D-insufficient women being at menopause for less and more than 5 years, respectively. In vitamin D-insufficient women that were less than 5 years at menopause, consumption of vitamin D-enriched cheese was also associated with lower serum PTH (Beta −0.63 ± 1.11; p < 0.001) and TRAP-5b (Beta −0.65 ± 0.23; p = 0.004) levels at follow-up, compared with the CG. The present study showed that daily intake of 5.7 μg of vitamin D through enriched cheese increased serum 25(OH)D concentrations, prevented PTH increase and reduced bone resorption in vitamin D-insufficient early postmenopausal women, thus reflecting a food-based solution for reducing osteoporosis risk in this susceptible group.

scholarly journals Effects of different 1-34 parathyroid hormone dosages on fibroblast growth factor-23 secretion in human bone marrow cells following osteogenic differentiation

2014 ◽  
Vol 6 (2) ◽  
Author(s):  
Frank-Peter Tillmann ◽  
Daniela Hofen ◽  
Monika Herten ◽  
Rüdiger Krauspe ◽  
Marcus Jäger
Keyword(s):  
Bone Marrow ◽  
Vitamin D ◽  
Parathyroid Hormone ◽  
Growth Factor ◽  
Osteogenic Differentiation ◽  
Fibroblast Growth Factor ◽  
Bone Marrow Cells ◽  
Fibroblast Growth ◽  
Trap 5B ◽  
Fgf 23

The importance of fibroblast growth factor (FGF)-23 as part of a hormonal bone-kidney-axis has been well established. Lately, FGF-23 has been suggested as an independent risk factor of death in patients on chronic hemodialysis. Hyperparathyroidism is a common feature of advanced kidney failure or end-stage renal disease. The independent effect of elevated parathyroid hormone (PTH) levels on FGF-23 secretion is still a matter of debate and has not yet been studied in an <em>in</em> <em>vitro</em> model of human bone marrow cells (BMC) during osteogenic differentiation. BMC from three different donors were cultivated for 4 weeks in cell cultures devoid of vitamin D either without 1-34 PTH or with PTH concentrations of 10 or 100 pmol/L, respectively. After 28 days, protein expression of the cells was determined by immunocytochemical staining, whereas real time-polymerase chain reaction served to analyze gene expression of several osteoblastic (osteocalcin, RANKL, Runx-2 and ostase) and osteoclastic markers (RANK, TRAP-5b). The concentrations of FGF-23, ostase and TRAP-5b were determined by ELISA at weeks 2, 3 and 4. We found a basal expression of FGF-23 with no increase in FGF-23 secretion after stimulation with 10 pmol/L 1-34 PTH. Stimulation with 100 pmol/L PTH resulted in an increase in FGF-23 expression (14.1±3.6 pg/mL with no PTH, 13.7±4.0 pg/mL with 10 pmol/L, P=0.84 and 17.6±3.4 pg/mL with 100 pmol/L, P=0.047). These results suggest a vitamin D and PTH-independent FGF-23 expression in human BMC after osteogenic stimulation. As only higher PTH levels stimulated FGF-23 expression, a threshold level might be hypothesized.

1216: Oral Treatment with a Vitamin D3 Analogue Shows Anti Inflammatory Effects and Reduces Bladder Overactivity in Rodent Models of Chronic Cystitis

2005 ◽  
Vol 173 (4S) ◽  
pp. 330-330
Author(s):  
Peter Zvara ◽  
Fabio Benigni ◽  
Enrico Baroni ◽  
Marija Zecevic ◽  
Antonia Monno ◽  
...  
Keyword(s):  
Vitamin D3 ◽  
Oral Treatment ◽  
Rodent Models ◽  
Chronic Cystitis ◽  
Anti Inflammatory

Vitamin D3 supplementation improves glycemic control in type 2 diabetic patients: Results from an Italian clinical trial

2020 ◽  
pp. 1-10
Author(s):  
Giuseppe Derosa ◽  
Angela D’Angelo ◽  
Chiara Martinotti ◽  
Maria Chiara Valentino ◽  
Sergio Di Matteo ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Metabolic Control ◽  
Vitamin D3 ◽  
Therapy Group ◽  
Hypoglycemic Agents ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic

Abstract. Background: to evaluate the effects of Vitamin D3 on glyco-metabolic control in type 2 diabetic patients with Vitamin D deficiency. Methods: one hundred and seventeen patients were randomized to placebo and 122 patients to Vitamin D3. We evaluated anthropometric parameters, glyco-metabolic control, and parathormone (PTH) value at baseline, after 3, and 6 months. Results: a significant reduction of fasting, and post-prandial glucose was recorded in Vitamin D3 group after 6 months. A significant HbA1c decrease was observed in Vitamin D3 (from 7.6% or 60 mmol/mol to 7.1% or 54 mmol) at 6 months compared to baseline, and to placebo (p < 0.05 for both). At the end of the study period, we noticed a change in the amount in doses of oral or subcutaneous hypoglycemic agents and insulin, respectively. The use of metformin, acarbose, and pioglitazone was significantly lower (p = 0.037, p = 0.048, and p = 0.042, respectively) than at the beginning of the study in the Vitamin D3 therapy group. The units of Lispro, Aspart, and Glargine insulin were lower in the Vitamin D3 group at the end of the study (p = 0.031, p = 0.037, and p = 0.035, respectively) than in the placebo group. Conclusions: in type 2 diabetic patients with Vitamin D deficiency, the restoration of value in the Vitamin D standard has led not only to an improvement in the glyco-metabolic compensation, but also to a reduced posology of some oral hypoglycemic agents and some types of insulin used.

Rationale Abklärung von Lebererkrankungen

2017 ◽  
Vol 74 (3) ◽  
pp. 79-86
Author(s):  
Leona von Köckritz ◽  
Andrea De Gottardi
Keyword(s):  
Acoustic Radiation ◽  
Radiation Force ◽  
Acoustic Radiation Force ◽  
Acoustic Radiation Force Impulse ◽  
Alkalische Phosphatase ◽  
Gamma Glutamyltransferase ◽  
Alpha 1 Antitrypsin

Zusammenfassung. Im klinischen Alltag werden häufig erhöhte Leberwerte beobachtet. In der Regel erfordern sie weitere Abklärungen bezüglich der möglichen Ätiologie und des Schweregrad einer akuten oder chronischen Lebererkrankung. Die Abklärung sollte dabei neben einer gezielten Anamnese und sorgfältigen klinischen Untersuchung, auch die Bestimmung von laborchemischen Markern für Cholestase und Leberfunktionsstörungen (wie Alkalische Phosphatase, gamma-Glutamyltransferase, Bilirubin, Albumin und Gerinnungsfaktoren) umfassen. Die Bestimmung weiterer Parameter wie Ferritin und Transferrinsättigung, Autoimmunantikörper, Virusserologien, alpha-1 Antitrypsin und Coerulolasmin können weitere Hinweise für die kausalen Zusammenhänge der Leberfunktionsstörung liefern. Bei Patienten mit Lebererkrankungen ist eine sonografische Beurteilung der Leber obligat. Ergänzend zur Sonografie werden heute weitere nicht-invasive Methoden wie Fibroscan, Acoustic Radiation Force Impulse Elastometrie und Magnet-Resonanz-Elastografie zur Beurteilung der Leberfibrose eingesetzt. In ausgewählten Fällen ist eine Leberbiopsie notwendig, um den Grad der Fibrose und die Ätiologie der Lebererkrankung zu eruieren. Mithilfe eines Fallbeispiels, diskutieren die Autoren im Folgenden die rationale Anwendung diagnostischer Tests und deren korrekte Interpretation und schlagen eine Orientierungshilfe zur rationalen Abklärung von Patienten mit Lebererkrankungen vor.

Vitamin D3 hochdosiert dreimal jährlich reduziert Frakturrate

Praxis ◽  
2003 ◽  
Vol 92 (47) ◽  
pp. 2021-2022
Author(s):  
K. Eichler
Keyword(s):  
Vitamin D3
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