ICCBH2017 Poster Presentations (1) (209 abstracts)
Sex and iron modify fibroblast growth factor 23 concentrations in 1-year-old children
Elisa Holmlund-Suila 1, , Maria Enlund-Cerullo 1, , Saara Valkama 1, , Helena Hauta-alus 1 , Jenni Rosendahl 1, , Otto Helve 1, , Heli Viljakainen 1, , Sture Andersson 1, & Outi Mäkitie 1,
1University of Helsinki, Helsinki, Finland; 2Helsinki University Hospital, Helsinki, Finland; 3Folkhälsan Research Centre, Helsinki, Finland.
Objectives: The regulation of fibroblast growth factor 23 (FGF23) metabolism during infancy is inadequately characterized. We previously observed a distinct sex difference in intact FGF23 at 3 months of age. In this study we aimed to further examine the role of sex and iron status in FGF23 metabolism in 1-year-old children.
Methods: This was a cross-sectional study including 731 1-year-old Caucasian children participating the Vitamin D intervention in infants (VIDI) trial in Finland. In this double-blind trial, healthy term infants are randomized to receive 10 or 30 μg vitamin D3 daily from 2 weeks to 2 years. We analyzed intact and C-terminal FGF23, 25OHD, PTH, calcium, phosphate and markers of iron status at 1 year.
Results: Intact FGF23 was higher in girls than in boys (median 44.3 vs 41.0 pg/ml, P<0.001) and C-terminal FGF23 did not differ between sexes (median 2.9 vs 2.8, P=0.403). These findings persisted after adjusting with growth parameters. Boys were bigger and had lower ferritin concentrations (median 18 vs 26 μg/l) than girls (P<0.001 for both). Iron status was positively associated with intact FGF23 and inversely with C-terminal FGF23 (P<0.001 for both). Iron was the strongest modifier of intact FGF23 concentration when season, sex, 25OHD, ionized calcium and ferritin were also included in the model: higher iron associated with higher intact FGF23 (P<0.001). In both boys and girls, iron (P<0.001 and P=0.001) and season (P<0.001 and P=0.031) remained significant modifiers. Furthermore in girls, 25OHD (P<0.001) and ionized calcium (P=0.003) were positively, and ferritin (P=0.043) inversely associated with intact FGF23.
Conclusion: Intact FGF23 was higher in girls than in boys, likely due to differences in growth and the demand for phosphate during infancy. Higher iron associated with higher intact FGF23 and lower C-terminal FGF23. Other modifiers of intact FGF23 included season, 25OHD, ionized calcium and ferritin.
Disclosure: The authors declared no competing interests.
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