Fibroblast growth factor 23 and its role in bone diseases

Abstract

Fibroblast growth factor 23 (FGF23) has been casually linked to numerous hypophosphatemic bone diseases, however connection with bone loss or fragility fractures is still a matter of debate. The purpose of this review is to explore and summarise the known actions of FGF23 in various pathological bone conditions. Besides implication in bone mineralisation, elevated FGF23 showed a pathological effecton bone remodelling, primarily by inhibiting osteoblast function. Unlike the weak association with bone mineral density, high values of FGF23 have been connected with fragility fracture prevalence. This review shows that its effects on bone are concomitantly present on multiple levels, affecting both qualitative and quantitative part of bone strength, eventually leading to impaired bone strength and increased tendency of fractures. Recognising FGF23 as a risk factor for the development of bone diseases and correcting its levels could lead to the reduction of morbidity and mortality in specific groups of patients.

Keywords:

• Fibroblast growth factor
• FGF23
• hypophosphatemic diseases
• osteoporosis
• fragility fractures
• chronic liver disease
• chronic kidney disease

Author contributions

Andrija Jurina and Marijana Vučić Lovrenčić had the idea for the article. Andrija Jurina, Valentina Delimar, Tomislav Dujmović and Mladen Japjec performed the literature search, while Dino Kasumović and Mario Starešinić revised the searched data. Andrija Jurina, Valentina Delimar, Tomislav Dujmović, Mladen Japjec and Dino Kasumović drafted the work. Marijana Vučić Lovrenčić, Tajana Filipec Kanižaj and Mario Starešinić critically revised the work.

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No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.