ArticleThe Journal of clinical endocrinology and metabolism2020
Intact and C-Terminal FGF23 Assays-Do Kidney Function, Inflammation, and Low Iron Influence Relationships With Outcomes?
Article in The Journal of clinical endocrinology and metabolism, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Fibroblast growth factor-23 and the risk of cardiovascular diseases and mortality in the general population: A systematic review and dose-response meta-analysis.Frontiers in cardiovascular medicine · 2022Pooled it
- Fibroblast Growth Factor 23 Trajectories in Children and Association with CKD Progression: The CKD in Children Study.Clinical journal of the American Society of Nephrology : CJASN · 2026Article
- Association between Serum Glycerol-3-Phosphate and Fibroblast Growth Factor-23 in Nondiabetic Patients on Hemodialysis.Clinical journal of the American Society of Nephrology : CJASN · 2026Article
- Current Controversies on Adequate Circulating Vitamin D Levels in CKD.International journal of molecular sciences · 2025Review
- Association of Fibroblast Growth Factor 23 and Cardiac Mechanics in the Cardiovascular Health Study.Kidney360 · 2025Article
- Klotho and Clinical Outcomes in CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2024Observational
- Associations of Intact and C-Terminal FGF23 with Inflammatory Markers in Older Patients Affected by Advanced Chronic Kidney Disease.Journal of clinical medicine · 2024Article
- Iron Deficiency and Incident Heart Failure in Older Community-Dwelling Individuals.ESC heart failure · 2024Article
- Association of mineral and bone biomarkers with adverse cardiovascular outcomes and mortality in the German Chronic Kidney Disease (GCKD) cohort.Bone research · 2023Article
- Intact FGF23 predicts serum phosphate improvement after combined nicotinamide and phosphate binder treatment in hemodialysis patients.Clinical kidney journal · 2023Article
- The open system of FGF-23 at the crossroad between additional P-lowering therapy, anemia and inflammation: how to deal with the intact and the C-terminal assays?Clinical kidney journal · 2023Article
- [Value of serum fibroblast growth factor 23 in diagnosis of hypophosphatemic rickets in children].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2023Article
- Urinary tetrahydroaldosterone is associated with circulating FGF23 in kidney stone formers.Urolithiasis · 2022Article
- Renal Clearance of Fibroblast Growth Factor-23 (FGF23) and its Fragments in Humans.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2022Article
- 18-year change in serum intact fibroblast growth factor 23 from midlife to late life and risk of mortality: the ARIC Study.European journal of endocrinology · 2022Article
- Determination of iFGF23 Upper Reference Limits (URL) in healthy pediatric population, for its better correct use.Frontiers in endocrinology · 2022Observational
- C-terminal and intact FGF23 in kidney transplant recipients and their associations with overall graft survival.BMC nephrology · 2021Observational
- An Overview of FGF-23 as a Novel Candidate Biomarker of Cardiovascular Risk.Frontiers in physiology · 2021Review
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 2 countries.
Funding
Abstract
contextHigher fibroblast growth factor-23 (FGF23) concentrations are associated with heart failure and mortality in diverse populations, but the strengths of associations differ markedly depending up on which assay is used.
objectiveWe sought to evaluate whether iron deficiency, inflammation, or kidney function account for differences in the strengths of associations between these 2 FGF23 assays with clinical outcomes.
designCase cohort study from the Cardiovascular Health Study.
settingA total of 844 community-dwelling individuals aged 65 years or older with and without chronic kidney disease were followed for 10 years. OUTCOMES: Outcomes included death, incident heart failure (HF), and incident myocardial infarction (MI). Exposure was baseline intact and C-terminal FGF23. Using modified Cox models, adjusting sequentially we tested whether observed associations of each assay with outcomes were attenuated by iron status, inflammation, kidney function, or their combinations.
resultsFGF23 measured by either assay was associated with mortality in unadjusted analysis (intact FGF23 hazard ratio [HR] per 2-fold higher 1.45; 95% CI, 1.25-1.68; C-terminal FGF23 HR 1.38; 95% CI, 1.26-1.50). Adjustment for kidney function completely attenuated associations of intact FGF23 with mortality (HR 1.00; 95% CI, 0.85-1.17), but had much less influence on the association of C-terminal FGF23, for which results remained significant after adjustment (HR 1.15; 95% CI, 1.04-1.28). Attenuation was much less with adjustment for iron status or inflammation. Results were similar for the HF end point. Neither C-terminal or intact FGF23 was associated with MI risk.
conclusionsThe relationship of FGF23 with clinical end points is markedly different depending on the type of FGF23 assay used. The associations of biologically active FGF23 with clinical end points may be confounded by kidney disease, and thus much weaker than previously thought.
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Registered trials
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