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Abstract: FR-PO224

Fibroblast Growth Factor 23 and Adiposity in Patients with CKD Stages 3 and 4

Session Information

Category: CKD (Non-Dialysis)

  • 1902 CKD (Non-Dialysis): Clinical, Outcomes, and Trials


  • Akwo, Elvis A., Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Robinson-Cohen, Cassianne, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Whitfield, Victoria, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Siew, Edward D., Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Ikizler, Talat Alp, Vanderbilt University Medical Center, Nashville, Tennessee, United States
  • Hung, Adriana, Veterans Affairs CSR&D, Nashville, Tennessee, United States

Adiposity has been associated with higher Fibroblast Growth Factor 23 (FGF23) levels in patients with normal kidney function. If this relationship is observed in patients with moderate chronic kidney disease (CKD) is unknown. We investigated the relationship between adiposity and FGF23 in a cohort of patients with stages 3-4 CKD.


This was a cross-sectional investigation of 71 CKD patients who underwent body composition and anthropometric assessments. Dual energy x-ray absorptiometry (DEXA) scans were used to measure total fat mass and body mass index (BMI) was computed using baseline weight and height measurements. Biomarkers included estimated glomerular filtration rate (eGFR), serum leptin, FGF23, high sensitivity C-reactive protein (hsCRP) and serum lipids. Ordinary least squares regression with the sandwich estimator of variance was used to investigate the relationship between FGF23 and measures of adiposity (BMI, total fat mass) and the pro-atherogenic adipocytokine leptin. Log-transformation was performed for variables with considerable skewness.


Mean (SD) age was 66 (12) years, 26% of participants were female, 23% were African-American. Median eGFR was 46.9 ml/min/1.73m2 (IQR 41.9, 52.8), median BMI was 31(IQR: 27, 35). Log FGF23 had a significant positive correlation with BMI (r = 0.27, p = 0.02), total fat mass (r = 0.30, p = 0.01) and serum leptin (r = 0.43, p < 0.0001). After full adjustment for age, sex, race, eGFR, log hsCRP, log HDL and log triglycerides, a 50% increase in FGF-23 was associated with 1 unit [95% I: 0.1, 1.9; p = 0.03] increase in BMI, 2.5 kgs [95% CI: 0.2, 4.8; p = 0.03] increase in total fat mass and a 6.7 ng/mL [95% CI: 1.0, 12.4; p = 0.02] increase in serum leptin.


We report in patients with stage 3 & 4 CKD a cross-sectional association between higher FGF23 and higher adiposity (BMI, total fat mass and the pro-atherogenic adipocytokine, leptin). The causes and the implications of these associations need to be further investigated. Particularly in bone and vascular health.


  • Veterans Affairs Support