Fibroblast Growth Factor 23, Glucose Homeostasis, and Incident Diabetes: Findings of 2 Cohort Studies
Authors' conclusion
Glucose loading has phosphate-independent effects on FGF23 and, vice versa, FGF23 is associated with glucose, insulin and proinsulin levels, and obesity. These findings suggest crosstalk between FGF23 and glucose homeostasis, which may promote susceptibility to incident diabetes.
Study context
- Population
- Overweight individuals (BMI 25–30) undergoing glucose loading; population-based cohort (mean age 52 years, 52% women, median FGF23 69 RU/mL)population-based cohort
- Participants
- 5,482 individuals
- Exposure
- Higher vs lower plasma C-terminal FGF23
- Outcome
- Incident diabetes
Methodological detailstime-lag analyses, cross-sectional multivariable linear regression, longitudinal multivariable Cox regression
- Time-lag analyses
- Cross-sectional multivariable linear regression
- Longitudinal multivariable Cox regression
Main finding
As reported in the abstract
Diabetes events
199 events
4%
Higher baseline FGF23, fully adjusted HR (95% CI) for incident diabetes
1.66
95% CI 1.06–2.60P = .03
Observational data: associations, not effects.
Further findings
Glucose loading: FGF23 vs plasma phosphate changes
- Changes in FGF23 preceded changes in plasma phosphate
- Ptime-lag = .04
- 45 overweight individuals
Cross-sectional associations of FGF23 at baseline
- Plasma glucose, β
- β = .13 [.03-.23]; P = .01
- Insulin, β
- β = .10 [.03-.17]; P < .001
- Proinsulin, β
- β = .06 [0.02-0.10]; P = .01
Incident obesity (BMI > 30)
- Obesity events
- 241 events [6%]
- Higher baseline FGF23, fully adjusted HR
- 1.84 [95% CI, 1.34-2.50]; P < .001 (95% CI)
Original publication
Fibroblast Growth Factor 23, Glucose Homeostasis, and Incident Diabetes: Findings of 2 Cohort Studies. J Clin Endocrinol Metab. Published 4 May 2023. doi:10.
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