Evaluating the Fibroblast Growth Factor-23 and Phosphate in Iraqi Patients with Acromegaly
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Abstract
Fibroblast growth factors-23 (FGF-23) are a class of cell signaling proteins produced by macrophages. They have a range of roles, but they play a particularly important role in the development of animal cells, where they are essential for appropriate growth. Phosphate, which is found in the body as both organic and mineral phosphate, plays crucial roles in cell structure, communication, and metabolism. Most phosphate in the body resides in bone, teeth, and inside cells, with less than 1% circulating in serum. The aim of the study is to evaluate the levels of the Fibroblast Growth Factors-23 and phosphate and receiver operating characteristic (ROC) in acromegaly patients against healthy control. A case control study Fibroblast Growth Factors-23, Phosphate, Growth hormone and Insulin like growth factor-1 were carried out by recruiting 61 acromegalic patients who were enrolled in the study plus 60 control group. The results showed significant higher values in Fibroblast Growth Factors-23 and Phosphate levels in acromegalic patients than healthy control group whereas the Mean±S.D was (3627.49±395.77, 1809.94±159.63) and (1.44±0.58, 0.59±0.26) and we found the Fibroblast Growth Factors-23 was high in control group among men versus women (1866.81±177.86, 1756.98±121.07) and (P value 0.009). According to the current study, patients with acromegaly have high significant Fibroblast Growth Factors-23 and phosphate levels than the healthy control group and they are the most specific and sensitive marker in acromegalic patients in a term of defining and excluding the disease
Received 29/03/2023,
Revised 02/07/2023,
Accepted 04/07/2023,
Published Online First 20/08/2023
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Hameed A Sh, Khalee F M, Rahma A M. Superoxide Dismutase and Glutathione S Transferase Enzymes Levels in Diabetic Iraqi Acromegalic Patients. Biochem Cell Arch. 2019; 19(Supplement 1): 2097-2100. https://www.researchgate.net/publication/337758920_SUPEROXIDE_DISMUTASE_AND_GLUTATHIONE_S_TRANSFERASE_ENZYMES_LEVELS_IN_DIABETIC_IRAQI_ACROMEGALIC_PATIENTS#:~:text=10.35124/bca.2019.19.S1.2097
Mahdi RA. Genetic study of AHR exonic part and GNAS intronic part mutations in some of Iraqi acromegalic patients. Endocr abstr. 2019 May;1 (63). https://doi.org/10.1530/endoabs.63.P250
Broersen LH, Zamanipoor Najafabadi AH, Pereira AM, Dekkers OM, van Furth WR, Biermasz NR. Improvement in symptoms and health-related quality of life in acromegaly patients. a systematic review and meta-analysis. J Clin Endocrinol Metab. 2021 Feb; 106(2); 577-87. https://doi.org/10.1210/clinem/dgaa868
Abd Aon YS, Kadhim SJ, Al-Samarriae AY. Studying the genotype of Aryl Hydrocarbon Receptor-Interacting Protein (AIP) Gene (rs641081C> A) in Iraqi Samples with Acromegaly Pituitary Adenoma. Baghdad Sci J. 2022 Dec; 1; 19(6): 1167. https://dx.doi.org/10.21123/bsj.2022.1616
- Slagboom TN, van Bunderen CC, De Vries R, Bisschop PH, Drent ML. Prevalence of clinical signs, symptoms and comorbidities at diagnosis of acromegaly. A systematic review in accordance with PRISMA guidelines. Pituitary. 2023 May; 20: 1-4. http://dx.doi.org/10.1007/s11102-023-01322-7
Schweizer JR, Schilbach K, Haenelt M, Giannetti AV, Bizzi MF, Soares BS, et al. Soluble alpha klotho in acromegaly. Comparison with traditional markers of disease activity. J Clin Endocrinol Metab. 2021 Aug; 106(8); e2887-99. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8277223/#:~:text=%C2%A010.1210/clinem/dgab257
Abass EA, Abed BA, Mohsin SN. Determination of Osteocalcin, Bone Alkaline Phosphatase, and Lysyl Oxidase in Iraqi Acromegalic Patients. Ibn al-Haitham j pure appl sci. 2018 May 17; 31(1); 172-9. https://jih.uobaghdad.edu.iq/index.php/j/article/view/1864#:~:text=DOI%3A-
Hameed AS, Khaleel FM, Rahma AM. The response of acromegalic patients (Diabetic versus non-diabetic) to Long-acting-repeatable Octreotide (LAR) in the presence or absence of Glutathion S transferase (GSTM1, GSTT1) Genes. J Pharm Sci Res. 2018; 10(12): 3090-3094.https://www.jpsr.pharmainfo.in/Documents/Volumes/vol10Issue12/jpsr10121814.pdf
Lu M, Flanagan JU, Langley RJ, Hay MP, Perry JK. Targeting growth hormone function: strategies and therapeutic applications. Signal Transduct Target Ther. 2019 Feb 8; 4(1): 3. https://doi.org/10.1038/s41392-019-0036-y
Kopchick JJ, Berryman DE, Puri V, Lee KY, Jorgensen JO. The effects of growth hormone on adipose tissue: old observations, new mechanisms. Nat Rev Endocrinol. 2020 Mar; 16(3): 135-46. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7180987/#:~:text=10.1038/s41574%2D019%2D0280%2D9
- Vila G, Jørgensen JO, Luger A, Stalla GK. Insulin resistance in patients with acromegaly. Front Endocrinol. 2019 Jul; 30: 10:509. https://pubmed.ncbi.nlm.nih.gov/31417493/#:~:text=DOI%3A-,10.3389/fendo.2019.00509,-Free%20PMC%20article
Akirov A, Masri-Iraqi H, Dotan I, Shimon I. The biochemical diagnosis of acromegaly. J Clin Med Res. 2021 Mar 9; 10(5):1147 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7967116/#:~:text=%C2%A010.3390/jcm10051147
Tahir NT, Abdulsattar SA, Alkazzaz FF. Assessment of Obesity, Dyslipidemia, Hyperglycemia, and Pro-Inflammatory Cytokines as Cardiovascular Disease Risk Factors in Acromegaly Patients. Baghdad Sci J. 2022 Oct 1; 19(5): 0976-http://dx.doi.org/10.21123/bsj.2022.6002
- Fleseriu M, Führer-Sakel D, van der Lely AJ, De Marinis L, Brue T, van der Lans-Bussemaker J, et al. More than a decade of real-world experience of pegvisomant for acromegaly. Acrostudy. Eur J Endocrinol. 2021 Oct; 185(4): 525-38. https://doi.org/10.1530%2FEJE-21-0239
Giustina A, Barkan A, Beckers A, Biermasz N, Biller BM, Boguszewski C, et al. A consensus on the diagnosis and treatment of acromegaly comorbidities. an update. J Clin Endocrinol Metab. 2020 Apr 1; 105(4): e937-46. 10.1210/clinem/dgz096 https://doi.org/10.1210/clinem/dgz096
Tönjes A, Quinkler M, Knappe U, Störmann S, Schöfl C, Schopohl J, et al. Treatment of acromegaly-data from the German Acromegaly Register. Dtsch Med. 2023 Mar 20; 148(7): 380-5. https://pubmed.ncbi.nlm.nih.gov/36940688/#:~:text=DOI%3A-,10.1055/a%2D1847%2D2553,-Abstract
Samson SL, Nachtigall LB, Fleseriu M, Gordon MB, Bolanowski M, Labadzhyan A, et.al. Maintenance of acromegaly control in patients switching from injectable somatostatin receptor ligands to oral octreotide. J Clin Endocrinol Metab 2020 Oct; 105(10): e3785-97. https://pubmed.ncbi.nlm.nih.gov/32882036/#:~:text=DOI%3A-,10.1210/clinem/dgaa526,-Free%20PMC%20article
Gadelha MR, Kasuki L, Lim DS, Fleseriu M. Systemic complications of acromegaly and the impact of the current treatment landscape: an update. Endocr Rev. 2019 Feb; 40(1): 268-332. https://pubmed.ncbi.nlm.nih.gov/30184064/#:~:text=DOI%3A-,10.1210/er.2018%2D00115,-Abstract
Zhang L, Qin W. Research progress of fibroblast growth factor 23 in acute kidney injury. Pediatr Nephrol.. 2022 Nov; 22: 1-0. https://doi.org/10.1007/s00467-022-05791-z
-Miyakawa H, Hsu HH, Ogawa M, Akabane R, Miyagawa Y, Takemura N. Serum fibroblast growth factor-23 concentrations in young and mature adult cats with chronic kidney disease. J Feline Med Surg. 2022 Aug; 24(8): 815-20. https://doi.org/10.1177/1098612x211039192
Ho BB, Bergwitz C. FGF23 signalling and physiology. J Mol Endocrinol. 2021 Feb; 66(2): R23. 10.1530/JME-20-0178 https://doi.org/10.1530/jme-20-0178
Takir M, Aksu F. Association between Coronary Flow Reserve, Klotho and Fibroblast Growth Factor 23 in Patients with Acromegaly. Eurasian J Med Oncol. 2019; 3(1): 14-21. https://dx.doi.org/10.14744/ejmo.2018.0068
Schmid C, Neidert MC, Tschopp O, Sze L, Bernays RL. Growth hormone and Klotho. J. Endocrinol. 2013; 219(2) :R37-57 https://doi.org/10.1530/JOE-13-0285
Clinkenbeard EL, White KE. Systemic control of bone homeostasis by FGF23 signaling. Curr Mol Biol Rep. 2016 Mar; 2: 62-71. http://dx.doi.org/10.1007/s40610-016-0035-5
Lederer E, Wagner CA. Clinical aspects of the phosphate transporters NaPi-IIa and NaPi-IIb: mutations and disease associations. Pflugers Arch. 2019 Jan 31; 471(1): 137-48. https://doi.org/10.1007/s00424-018-2246-5
Bär L, Stournaras C, Lang F, Föller M. Regulation of fibroblast growth factor 23 (FGF 23) in health and disease. FEBS Lett. 2019 Aug; 593(15): 1879-900. https://doi.org/10.1002/1873-3468.13494
Haffner D, Grund A, Leifheit-Nestler M. Renal effects of growth hormone in health and in kidney disease. Pediatr Nephrol. 2021 Aug; 36(8): 2511-30. https://doi.org/10.1007/s00467-021-05097-6
Xie T, Tian P, Wu S, Zhang X, Liu T, Gu Y, et al. Serum phosphate: Does it more closely reflect the true state of acromegaly?. J Clin Neurosci. 2020 Jan 1; 71: 26-31. https://doi.org/10.1016/j.jocn.2019.11.012
Rausch S, Föller M. The regulation of FGF23 under physiological and pathophysiological conditions. Pflugers Arch. 2022 Mar; 474(3): 281-92. https://doi.org/10.1007/s00424-022-02668-w
Edmonston D, Wolf M. FGF23 at the crossroads of phosphate, iron economy and erythropoiesis. Nat Rev Nephrol. 2020 Jan; 16(1): 7-19. https://doi.org/10.1038/s41581-019-0189-5
David V, Martin A, Isakova T, Spaulding C, Qi L, Ramirez V. et al. Inflammation and functional iron deficiency regulate fibroblast growth factor 23 production. Kidney Int. 2016; 89(1): 135–146. https://doi.org/10.1038/ki.2015.290
Vervloet M. Renal and extrarenal effects of fibroblast growth factor 23. Nat Rev Nephrol. 2019 Feb; 15(2): 109-20 https://doi.org/10.1038/s41581-018-0087-2 .
Yalin GY, Tanrikulu S, Gul N, Uzum AK, Aral F, Tanakol R. Utility of baseline serum phosphorus levels for predicting remission in acromegaly patients. J Endocrinol Invest. 2017 Aug; 40: 867-74. https://doi.org/10.1007/s40618-017-0657-3
Droste M, Domberg J, Buchfelder M, Mann K, Schwanke A, Stalla G, Strasburger CJ. Therapy of acromegalic patients exacerbated by concomitant type 2 diabetes requires higher pegvisomant doses to normalise IGF1 levels. Eur J Endocrinol. 2014 Jul; 171(1): 59-68. https://doi.org/10.1530/eje-13-0438
Li X, Ni X, Chai X, Wang L, Jiang Y, Jing H, et al. Tumor‐induced osteomalacia combined with acromegaly: A case report. Ann N Y Acad Sci. 2022 Nov; 1517(1): 88-92. https://doi.org/10.1111/nyas.14893
Tonelli M, Sacks F, Pfeffer M, Gao Z, Curhan G. Relation between serum phosphate level and cardiovascular event rate in people with coronary disease. Circulation. 2005 Oct 25; 112(17): 2627-33. https://doi.org/10.1161/circulationaha.105.553198
Foley RN. Phosphate levels and cardiovascular disease in the general population. Clin J Am Soc Nephrol. 2009 Jun 1; 4(6): 1136-9. https://doi.org/10.2215/cjn.01660309
Quarles LD. Endocrine functions of bone in mineral metabolism regulation J Clin Investig. 2008 Dec 1; 118(12): 3820-8. https://doi.org/10.1172/jci36479
Kamenický P, Blanchard A, Gauci C, Salenave S, Letierce A, Lombès M, et al. Pathophysiology of renal calcium handling in acromegaly: what lies behind hypercalciuria?. J Clin Endocrinol Metab. 2012 Jun 1; 97(6): 2124-33. https://doi.org/10.1210/jc.2011-3188
Bacchetta J, Cochat P, Salusky IB, Wesseling-Perry K. Uric acid and IGF1 as possible determinants of FGF23 metabolism in children with normal renal function. Pediatr Nephrol. 2012 Jul; 27: 1131-8. https://doi.org/10.1007%2Fs00467-012-2110-3
Ito N, Fukumoto S, Taguchi M, Takeshita A, Takeuchi Y, Yamada S, et al. Fibroblast growth factor (FGF) 23 in patients with acromegaly. Endocr J. 2007; 54(3): 481-4. https://doi.org/10.1507/endocrj.k06-217