Fibroblast Growth Factor-23 Relationship to Dietary Phosphate and Renal Phosphate Handling in Healthy Young Men
Abstract
The renal handling of inorganic phosphate (Pi) is controlled not only by PTH, but also by hitherto undetermined mechanisms dependent on phosphate intake. Recently, fibroblast growth factor (FGF)-23 was identified as a novel phosphaturic factor in tumor-induced osteomalacia and autosomal-dominant hypophosphatemic rickets. We hypothesized that phosphate intake could influence FGF-23 concomitantly to the changes in renal Pi handling. Twenty-nine healthy males were subjected to a 5-d low-phosphate diet and a phosphate binder, followed by a high-phosphate diet including supplements. Concomitant modifications in calcium intake allowed minimizing PTH changes in response to dietary phosphate. Serum FGF-23 levels significantly decreased on the low-phosphate diet, then increased with the oral phosphate load. Changes in FGF-23 were positively correlated with changes in 24-h urinary Pi excretion and negatively correlated with changes in the maximal tubular reabsorption of Pi and 1,25(OH)(2)D(3) (calcitriol), whereas PTH was not. In multivariate analysis, changes in FGF-23 remained the most significantly correlated to changes in 1,25(OH)(2)D(3) and maximal tubular reabsorption of Pi. Moreover, FGF-23 was positively correlated to serum osteocalcin, a marker of osteoblastic activity. In summary, FGF-23 was inversely related to renal Pi transport and serum calcitriol levels in healthy young men. These data suggest that FGF-23 may be implicated in the physiological regulation of Pi homeostasis in response to dietary phosphate changes, independent of PTH.
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Two to five days of high dietary Pi intake increases iFGF23 but not cFGF23.
“Two to five days of high dietary Pi intake increases iFGF23 but not cFGF23 [20, 25, 34, 58].”
From Controlled dietary phosphate loading in healthy young men elevates plasma phosphate and FGF23 levels (2025) · cites this paper as [20]
In mixed sex, intermediate-term studies, oral, enteral, or intravenous Pi loading increased iFGF23 and urinary Pi excretion.
“In mixed sex, intermediate-term studies, oral, enteral, or intravenous Pi loading increased iFGF23 and urinary Pi excretion, while enteral and intravenous Pi loading additionally increased serum Pi, and PTH, and decreased calcitriol [2, 20, 25, 50, 58].”
From Controlled dietary phosphate loading in healthy young men elevates plasma phosphate and FGF23 levels (2025) · cites this paper as [20]
In mixed sex, intermediate-term studies, enteral and intravenous Pi loading increased serum Pi and PTH and decreased calcitriol.
“In mixed sex, intermediate-term studies, oral, enteral, or intravenous Pi loading increased iFGF23 and urinary Pi excretion, while enteral and intravenous Pi loading additionally increased serum Pi, and PTH, and decreased calcitriol [2, 20, 25, 50, 58].”
From Controlled dietary phosphate loading in healthy young men elevates plasma phosphate and FGF23 levels (2025) · cites this paper as [20]
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Controlled dietary phosphate loading in healthy young men elevates plasma phosphate and FGF23 levels
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- Authors
- Ferrari, S. L., Bonjour, J.-P., & Rizzoli, R.
- Affiliations
- World Health Organization (CH)
- Service of Bone Diseases [World Health Organization Collaborating Center for Osteoporosis Prevention], Department of Rehabilitation and Geriatrics, Geneva University Hospital, Geneva 1211, Switzerland
- ORCID
- Ferrari, Serge L.
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2005-03-01
- Volume
- 90
- Issue
- 3
- Pages
- 1519-1524
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2037498463
- Cited by
- 518
- References
- 35
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 12 · 2023: 13 · 2022: 19 · 2021: 31 · 2020: 22 · 2019: 23 · 2018: 27 · 2017: 21 · 2016: 27 · 2015: 21 · 2014: 27 · 2013: 34 · 2012: 45
- FWCI
- 19.19
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Nephrology › Parathyroid Disorders and Treatments
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Alkaline Phosphatase Research Studies
- Keywords
- fibroblast growth factor 23, dietary phosphorus, renal phosphate handling, inorganic phosphate homeostasis, parathyroid hormone, 1,25-dihydroxyvitamin D3, phosphate reabsorption, osteocalcin, phosphate binders, low phosphate diet, healthy young men
- MeSH terms
- Fibroblast Growth Factor-23, Adult, Calcitriol, Calcium, Dietary, Fibroblast Growth Factors, Homeostasis, Humans, Kidney, Male, Parathyroid Hormone, Phosphates, Osteocalcin, Phosphorus, Dietary
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