Fibroblast Growth Factor 23, Parathyroid Hormone, and 1α, 25-Dihydroxyvitamin D in Surgically Treated Primary Hyperparathyroidism

Tebben, Peter J.; Singh, Ravindern J.; Clarke, Bart L.; Kumar, Rajiv
December 2004
Mayo Clinic Proceedings;Dec2004, Vol. 79 Issue 12, p1508
Academic Journal
OBJECTIVE: To determine whether fibroblast growth factor 23 (FGF23) contributes to the hypophosphatemia of primary hyperparathyroidism. PATIENTS AND METHODS: Thirteen adult patients with primary hyperparathyroidism had serum collected before and after parathyroidectomy for analysis of inorganic phosphorus, calcium, 1α,25-dihydroxyvitamin D (1α,25[OH]2D), parathyroid hormone (PTH), FGF23, creatinine, and bone-specific alkaline phosphatase (BSAP). Patients were recruited between July 24, 2003, and February 11, 2004. RESULTS: Before surgery, patients had elevated serum calcium and PTH concentrations. Serum phosphorus concentration were in the low-normal range. The FGF23 concentrations were not elevated in patients with primary hyperparathyroidism compared with healthy controls. Within 24 hours of surgery, serum calcium, PTH, 1α,25(OH)2D, and BSAP concentrations were lower (P<.002 for all) and phosphorous concentrations were higher (P=.003) than in the preoperative state. The FGF23 concentrations were similar 1 day and 6 weeks after surgery. The FGF23 concentrations did not correlate with serum phosphorus, calcium PTH, 1α,25(OH)2D, creatinine, or BSAP concentrations in the preoperative or postoperative state. CONCLUSION: Parathyroid hormone is the major regulator of serum phosphorus concentrations in patients with primary hyperparathyroidism. Fibroblast growth factor 23 does not appear to play a role in phosphorus homeostatis in patients with surgically treated primary hyperparathyroidism.


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