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The relationship between serum fibroblast growth factor 23, Klotho, and lumbar spine bone mineral density in northern Chinese postmenopausal women

Han, Wen, PhD1; Bai, Xiao-juan, MD1; Han, Lu-lu, PhD1; Sun, Xue-feng, PhD2; Chen, Xiang-mei, PhD2

doi: 10.1097/GME.0000000000001276
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Objectives: Changes in serum protein levels of fibroblast growth factor 23 (FGF23) and Klotho resulting from bone metabolism are still controversial. The purpose of this study was to observe the relationship between FGF23 and Klotho serum proteins and lumbar spine bone mineral density (LBMD) in northern Chinese postmenopausal women.

Methods: This was a community-based cross-sectional study carried out in Shenyang, a northern Chinese city. The study included 355 postmenopausal women with an average age of 62.92 ± 8.78 years. FGF23 and Klotho serum proteins were measured using a sandwich enzyme immunoassay. LBMD was examined using dual-energy X-ray absorptiometry. Pearson's correlation and regression analyses were performed to investigate the associations among them.

Results: The LgKlotho was positively correlated with LBMD (r = 0.105). There was a linear relationship between LgKlotho serum levels and LBMD (P = 0.007) after adjusting for BMI, and the relationship still existed after adjustments for many confounding variables (P = 0.045), including age, BMI, systolic blood pressure, diastolic blood pressure, total protein, total bilirubin, high-density lipoprotein cholesterol, fasting blood glucose, serum calcium, estimated glomerular filtration rate, serum uric acid, estradiol, cigarette smoking, alcohol consumption, milk intake, calcium and vitamin D supplements, physical exercise, and fracture history in postmenopausal women. FGF23 serum levels were, however, not significantly associated with LBMD.

Conclusions: Klotho was positively correlated with LBMD, and there was a linear relationship between Klotho serum protein levels and LBMD; however, the levels of serum Klotho were not independently associated with reduced LBMD in northern Chinese postmenopausal women. Moreover, serum FGF23 levels were not significantly related to LBMD in this sample population.

1Department of Gerontology and Geriatrics, Shengjing Hospital of China Medical University, Shenyang, China

2Department of Nephrology, General Hospital of Chinese People's Liberation Army, Beijing, China.

Address correspondence to: Xiao-juan Bai, MD, Department of Gerontology and Geriatrics, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning, China. E-mail: mailto: xiaojuan.bai@163.com

Received 24 August, 2018

Revised 15 October, 2018

Accepted 15 October, 2018

Funding/support: This work was supported by the National Basic Research Program of China (973 Program 2007CB507405, and 2013CB530804).

Financial disclosure/conflicts of interest: None reported.

© 2019 by The North American Menopause Society.