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J. Clin. Med. 2018, 7(12), 558; https://doi.org/10.3390/jcm7120558

Fibroblast Growth Factor 23 to Alpha-Klotho Index Correlates with Systemic Sclerosis Activity: A Proposal for Novel Disease Activity Marker

1
Department of Internal Medicine Rheumatology and Clinical Immunology Medical Faculty in Katowice Medical University of Silesia Katowice, 40-635 Katowice, Poland
2
Szpital Miejski w Sosnowcu, 41-200 Sosnowiec, Poland
3
Department of Statistics, Department of Instrumental Analysis, School of Pharmacy with the Division of Laboratory Medicine in Sosnowiec, Medical University of Silesia, Katowice, 41-200 Sosnowiec, Poland
4
Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia in Katowice, 40-752 Katowice, Poland
5
Department of Internal Medicine and Oncological Chemotherapy, Medical Faculty in Katowice, Medical University of Silesia in Katowice, 40-038 Katowice, Poland
*
Author to whom correspondence should be addressed.
Received: 2 November 2018 / Revised: 10 December 2018 / Accepted: 14 December 2018 / Published: 17 December 2018
(This article belongs to the Section Molecular Medicine)
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Abstract

Systemic sclerosis, a connective tissue disease, is characterized by thickening of the skin, massive fibrosis of internal organs, vasculopathy, and immune system functioning aberration. Recently, vitamin D (VD) deficit, seen almost universally in patients with systemic sclerosis (SSc), has gained much attention. VD metabolism is precisely orchestrated at the level of the kidney by regulators: parathyroid hormone (PTH) and fibroblast growth factor 23 (FGF23) and their receptors with a FGF23 co-receptor—α-Klotho. The aim of this study was to assess the levels of VD, α-Klotho, FGF23 in SSc patients and to find the relationship between those parameters and disease activity. We enrolled 48 SSc patients with a diffuse variant of SSc and 23 sex- and age-matched healthy volunteers that served as the control group (CG). Patients were characterized by lower level of VD in comparison to CG (19.8 (12.6–28.9) vs. 24.5 (21.3–31.5) ng/mL; p < 0.01), significantly reduced levels of iFGF23 (19.3 (12.1–30.5) vs. 73.9 (59.7–110.2) pg/mL p < 0.001), and similar α-Klotho concentrations (1415 ± 557 vs. 1526 ± 397 pg/mL), respective. None of these parameters correlated with the extent of skin involvement (modified Rodnan Skin Score) and disease activity according to Eustar 2017 guidelines. The FGF23/α-Klotho index was significantly reduced in SSc patients (0.013 (0.0081–0.025) vs. 0.055 (0.038–0.095); p < 0.001), and its log10 correlated (r = 0.35; p < 0.001) with disease activity score (Eular2017). Our data showed that the FGF23/α-Klotho index may be considered as a novel, potential marker of systemic sclerosis activity. View Full-Text
Keywords: fibroblast growth factor 23; α-Klotho; vitamin D; systemic sclerosis; disease activity fibroblast growth factor 23; α-Klotho; vitamin D; systemic sclerosis; disease activity
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Kotyla, P.J.; Kruszec-Zytniewska, A.; Owczarek, A.J.; Olszanecka-Glinianowicz, M.; Chudek, J. Fibroblast Growth Factor 23 to Alpha-Klotho Index Correlates with Systemic Sclerosis Activity: A Proposal for Novel Disease Activity Marker. J. Clin. Med. 2018, 7, 558.

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