FGF23 levels as a marker of physical performance and falls in community-dwelling very old individuals

Author(s)

Mariana Zuccolotto Foroni ^[1] ; Maysa Seabra Cendoroglo ^[2] ; Aline Granja Costa ^[3] ; Rosangela Villa Marin-Mio ^[4] ; Patricia Ferreira do Prado Moreira ^[5] ; Sergio Setsuo Maeda ^[6] ; John P. Bilezikian ^[7] ; Marise Lazaretti-Castro ^[8]

Affiliation

^[1] Universidade Federal de São Paulo. Escola Paulista de Medicina. Divisão de Endocrinologia - Brasil

^[2] Universidade Federal de São Paulo. Escola Paulista de Medicina. Divisão de Geriatria - Brasil

^[3] Universidade Federal de São Paulo. Escola Paulista de Medicina. Divisão de Endocrinologia - Brasil

^[4] Universidade Federal de São Paulo. Escola Paulista de Medicina. Divisão de Endocrinologia - Brasil

^[5] Universidade Federal de São Paulo. Escola Paulista de Medicina. Divisão de Geriatria - Brasil

^[6] Universidade Federal de São Paulo. Escola Paulista de Medicina. Divisão de Endocrinologia - Brasil

^[7] Columbia University. College of Physicians and Surgeons. Department of Medicine, Division of Endocrinology - Estados Unidos

^[8] Universidade Federal de São Paulo. Escola Paulista de Medicina. Divisão de Endocrinologia - Brasil

• Document type: Journal article
• Source: ARCHIVES OF ENDOCRINOLOGY METABOLISM; v. 66, n. 3, p. 333-344, 2022-06-03.

Abstract

ABSTRACT Objective: The fibroblast growth factor 23 (FGF23) has been related to biological aging, but data in elderly individuals are scant. We determined the profile of serum FGF23 levels in a population of very-old individuals and studied their correlations with parameters of bone metabolism and health markers, as functional performance. Materials and methods: This cross-sectional study was performed on 182 community dwellers aged ≥ 80 years. Serum levels of FGF23, PTH, calcium, albumin, phosphorus, creatinine, bone markers, and bone mineral density data were analyzed. Physical performance was evaluated with the stationary march (Step), Flamingo, and functional reach tests, along with questionnaires to assess falls and fractures in the previous year, energy expenditure (MET), and the Charlson index (CI). Physical activity was evaluated with the International Physical Activity Questionnaire (IPAQ). Results: Most participants (75%) had FGF23 levels between 30-120 RU/mL (range: 6.0-3,170.0 RU/mL). FGF23 levels correlated with estimated glomerular filtration rate (eGFR; r = -0.335; p = 0.001) and PTH (r = 0.318; p < 0.0001). Individuals with FGF23 in the highest tertile had more falls in the previous year (p = 0.032), worse performance in the Flamingo (p = 0.009) and Step (p < 0.001) tests, worse CI (p = 0.009) and a trend toward sedentary lifestyle (p = 0.056). On multiple regression, FGF23 tertiles remained significant, independently of eGFR, for falls in the previous year, performance in the Flamingo and stationary march tests, lean mass index, and IPAQ classification. Conclusion: In a population of very elderly individuals, FGF23 levels were inversely associated with neuromuscular and functional performances. Higher concentrations were related to more falls, lower muscle strength and aerobic capacity, and poorer balance, regardless of renal function, suggesting a potentially deleterious role of high FGF23 concentrations in musculoskeletal health. (AU)

• FAPESP's process: 11/12753-8 - Renal function markers, vitamin D and functional capacity in elderly
• Grantee: Maysa Seabra Cendoroglo
• Support Opportunities: Regular Research Grants