The FGF23/α-Klotho Axis in Postmenopausal Osteoporosis: Associations with Bone Mineral Density and Diagnostic Discrimination
Abstract
Background: Fibroblast growth factor 23 (FGF23) and α-Klotho are key regulators of mineral metabolism and bone homeostasis; however, their combined diagnostic value in postmenopausal osteoporosis remains incompletely understood. This study investigated the associations of serum FGF23, α-Klotho, and the FGF23/α-Klotho ratio with bone mineral density (BMD), bone turnover markers, and their diagnostic performance for postmenopausal osteoporosis. Methods: This cross-sectional study included 165 women divided into three groups: premenopausal healthy controls (n = 55), postmenopausal non-osteoporotic women (n = 55), and postmenopausal women with osteoporosis (n = 55). Serum FGF23 and α-Klotho concentrations were measured by enzyme-linked immunosorbent assay. Bone mineral density was assessed by dual-energy X-ray absorptiometry. Correlation analyses, age- and BMI-adjusted partial correlations, multivariable linear and logistic regression analyses, receiver operating characteristic (ROC) analyses, and incremental diagnostic models were performed. Diagnostic ROC and incremental model analyses were restricted to postmenopausal women (n = 110). Results: Serum FGF23 concentrations and the FGF23/α-Klotho ratio increased progressively across the study groups, whereas α-Klotho levels decreased (all p p p p p = 0.001), whereas its performance did not differ significantly from that of α-Klotho (ΔAUC = 0.038, p = 0.270). Adding FGF23 and α-Klotho to age, BMI, and 25-hydroxyvitamin D increased…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 165 participants or records.
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