Georgiadou Effrosyni, Marketou Helen, Trovas George, Dontas Ismene, Papaioannou Nikolaos, Makris Konstantinos, Galanos Antonios, Papavassiliou Athanasios
Th. Garofalidis Laboratory for Research of the Musculoskeletal System, Medical School, National & Kapodistrian University of Athens
Department of Biochemistry, KAT Hospital, Athens, Greece.
In Vivo. 2017 Jan 2;31(1):145-150. doi: 10.21873/invivo.11038.
To evaluate the short-term effects of calcitriol and sevelamer hydrochloride on fibroblast growth factor-23 (FGF23) in humans and to determine whether the effect is direct or indirect through calcitriol-induced increased absorption of phosphorus from the intestine.
A total of 15 healthy individuals were tested at three time points and stages, for 24 h and at 1-week intervals. During each stage, blood samples were taken at three time points (0, 8 and 24 h); baseline stage: under no intervention; second stage, while receiving 0.5 μg calcitriol orally twice daily; and at the third stage, while receiving 0.5 μg calcitriol orally twice daily and sevelamer hydrochloride during meals. The changes in FGF23, parathyroid hormone, calcitriol, Ca, and phosphorus were determined.
During calcitriol administration, the FGF23 level changed significantly (p=0.008), with the level at 24 h levels being significantly higher than at 8 h (8.8 pg/ml vs. 13.0 pg/ml, p=0.036). There was a statistically significant difference in the percentage change, among the three stages, at time 8 to 24 h and 0 to 24 h for FGF23 (p=0.014 and p=0.015, respectively), with significant differences between baseline vs. calcitriol for 8 to 24 h FGF23 change (-9.23% vs. 26.98%, p=0.003) and a trend between baseline vs. calcitriol (p=0.061) and calcitriol plus sevelamer (p=0.069) for 0 to 24 h FGF23 change.
Administration of calcitriol to healthy individuals increases the circulating level of FGF23 within 24 h. Combined calcitriol and sevelamer administration restrains the increase of FGF23, suggesting that calcitriol-induced increased absorption of phosphate from the intestine might also be involved in the increase of FGF23.
评估骨化三醇和盐酸司维拉姆对人体成纤维细胞生长因子-23（FGF23）的短期影响，并确定该影响是直接的还是通过骨化三醇诱导肠道对磷吸收增加而间接产生的。
共15名健康个体在三个时间点和阶段接受测试，为期24小时，间隔1周。在每个阶段，于三个时间点（0、8和24小时）采集血样；基线阶段：无干预；第二阶段，每天口服两次0.5μg骨化三醇；第三阶段，每天口服两次0.5μg骨化三醇且在进餐时服用盐酸司维拉姆。测定FGF23、甲状旁腺激素、骨化三醇、钙和磷的变化。
在服用骨化三醇期间，FGF23水平有显著变化（p = 0.008），24小时时的水平显著高于8小时时的水平（8.8 pg/ml对13.0 pg/ml，p = 0.036）。在三个阶段中，FGF23在8至24小时和0至24小时的百分比变化存在统计学显著差异（分别为p = 0.014和p = 0.01；基线与骨化三醇组相比，8至24小时FGF23变化有显著差异（-9.23%对26.98%，p = 0.003），基线与骨化三醇组（p = 0.061）以及骨化三醇加司维拉姆组（p = 0.069）之间，0至24小时FGF23变化有趋势差异。
对健康个体给予骨化三醇可在24小时内增加FGF23的循环水平。联合使用骨化三醇和司维拉姆可抑制FGF23的升高，提示骨化三醇诱导的肠道对磷酸盐吸收增加可能也参与了FGF23的升高。
