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Journal of Endocrinological Investigation

Erschienen in:

01.05.2022 | Original Article

A decrease in serum 1,25(OH)₂D after elective hip replacement and during bone healing is associated with changes in serum iron and plasma FGF23

verfasst von: J. Vaculik, L. Wenchich, M. Bobelyak, K. Pavelka, J. J. Stepan

Erschienen in: Journal of Endocrinological Investigation | Ausgabe 5/2022

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Abstract

Objective

Although calcitriol is essential for bone healing, its serum concentrations are low after hip surgery, and they continue to decline during bone healing. This study aimed to test the hypothesis of an association of changes in calcitriol production with the status of fibroblast growth factor 23 (FGF23) and iron deficiency after elective hip replacement for coxarthrosis.

Methods

In this prospective study, we measured the biomarkers of 17 patients undergoing elective hip replacement on admission, on the first day after surgery, and at the regular check-up after 48 ± 8 days. The serum concentrations of 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, transferrin, ferritin, parathyroid hormone, intact plasma FGF23 (iFGF23) and C-terminal FGF23 (cFGF23) were determined.

Results

In our patients who underwent elective hip replacement, significant correlations existed between the percent change in the conversion rate of 25(OH)D to 1,25(OH)₂D, plasma intact to C-terminal FGF23 ratio, and serum iron.

Conclusions

The production of calcitriol is compromised after elective hip replacement surgery, leading to reduced levels of active vitamin D in the serum. Significant correlations between the percent change in the conversion rate of 25(OH)D to 1,25(OH)₂D, plasma intact to C-terminal FGF23 ratio, and serum iron on the first day as well as 7 weeks after surgery could inspire future studies to determine whether and how calcitriol deficiency should be corrected, especially in fracture cases.

Kanis JA, Johnell O, Oden A et al (2008) FRAX and the assessment of fracture probability in men and women from the UK. Osteoporos Int 19:385–397PubMedPubMedCentralCrossRef

Wang N, Chen Y, Ji J et al (2020) The relationship between serum vitamin D and fracture risk in the elderly: a meta-analysis. J Orthop Surg Res 15:81PubMedPubMedCentralCrossRef

Lips P, Netelenbos JC, Jongen MJM et al (1982) Histomorphometric profile and vitamin D status in patients with femoral neck fracture. Metab Bone Dis Rel Res 4:85–93CrossRef

Meller Y, Kestenbaum RS, Shany S et al (1985) Parathormone, calcitonin, and vitamin D metabolites during normal fracture healing in geriatric patients. Clin Orthop Relat Res 199:272–279CrossRef

Yu-Yahiro JA, Michael RH, Dubin NH et al (2001) Serum and urine markers of bone metabolism during the year after hip fracture. J Am Geriatr Soc 49:877–883PubMedCrossRef

Briggs AD, Kuan V, Greiller CL et al (2013) Longitudinal study of vitamin D metabolites after long bone fracture. J Bone Miner Res 28:1301–1307PubMedCrossRef

Blomberg Jensen M, Husted H, Bjerrum PJ et al (2018) Compromised activation of vitamin D after elective surgery: a prospective pilot study. JBMR Plus 2:281–288PubMedPubMedCentralCrossRef

Zura R, Xiong Z, Einhorn T et al (2016) Epidemiology of fracture nonunion in 18 human bones. JAMA Surg 151:e162775PubMedCrossRef

Sim DS, Tay K, Howe TS et al (2021) Preoperative severe vitamin D deficiency is a significant independent risk factor for poorer functional outcome and quality of life 6 months after surgery for fragility hip fractures. Osteoporos Int 32:2217–2224PubMedCrossRef

10.

Bouillon R, Carmeliet G, Verlinden L et al (2008) Vitamin D and human health: lessons from vitamin D receptor null mice. Endocr Rev 29:726–776PubMedPubMedCentralCrossRef

11.

Fu L, Tang T, Miao Y et al (2009) Effect of 1,25-dihydroxy vitamin D3 on fracture healing and bone remodeling in ovariectomized rat femora. Bone 44:893–898PubMedCrossRef

12.

Lips P (2007) Relative value of 25(OH)D and 1,25(OH)2D measurements. J Bone Miner Res 22:1668–1671PubMedCrossRef

13.

Meller Y, Shainkin-Kestenbaum R, Shany S et al (1984) Parathyroid hormone, calcitonin, and vitamin D metabolites during normal fracture healing in humans. A preliminary report. Clin Orthop Relat Res 183:238–245CrossRef

14.

Lidor C, Dekel S, Edelstein S (1987) The metabolism of vitamin D3 during fracture healing in chicks. Endocrinology 120:389–393PubMedCrossRef

15.

Alkalay D, Shany S, Dekel S (1989) Serum and bone vitamin D metabolites in elective patients and patients after fracture. J Bone Jt Surg Br 71:85–87CrossRef

16.

Kato A, Bishop JE, Norman AW (1998) Evidence for a 1 alpha,25-dihydroxyvitamin D3 receptor/binding protein in a membrane fraction isolated from a chick tibial fracture-healing callus. Biochem Biophys Res Commun 244:724–727PubMedCrossRef

17.

Tauber C, Noff D, Noff M et al (1990) Blood levels of active metabolites of vitamin D3 in fracture repair in humans. A preliminary report. Arch Orthop Trauma Surg 109:265–267PubMedCrossRef

18.

Jingushi S, Iwaki A, Higuchi O et al (1998) Serum 1alpha,25-dihydroxyvitamin D3 accumulates into the fracture callus during rat femoral fracture healing. Endocrinology 139:1467–1473PubMedCrossRef

19.

St-Arnaud R, Naja RP (2011) Vitamin D metabolism, cartilage and bone fracture repair. Mol Cell Endocrinol 347:48–54PubMedCrossRef

20.

Yoshiko Y, Wang H, Minamizaki T et al (2007) Mineralized tissue cells are a principal source of FGF23. Bone 40:1565–1573PubMedCrossRef

21.

Goebel S, Lienau J, Rammoser U et al (2009) FGF23 is a putative marker for bone healing and regeneration. J Orthop Res 27:1141–1146PubMedCrossRef

22.

Verstuyf A, Carmeliet G, Bouillon R et al (2010) Vitamin D: a pleiotropic hormone. Kidney Int 78:140–145PubMedCrossRef

23.

Quarles LD (2012) Skeletal secretion of FGF-23 regulates phosphate and vitamin D metabolism. Nat Rev Endocrinol 8:276–286PubMedPubMedCentralCrossRef

24.

Bosworth C, de Boer IH (2013) Impaired vitamin D metabolism in CKD. Semin Nephrol 33:158–168PubMedPubMedCentralCrossRef

25.

Vaculik J, Wenchich L, Bobelyak M et al (2021) Decrease in serum calcitriol (but not free 25-hydroxyvitamin D) concentration in hip fracture healing. J Endocrinol Invest 44:1847–1855PubMedCrossRef

26.

Rupp T, Butscheidt S, Vettorazzi E et al (2019) High FGF23 levels are associated with impaired trabecular bone microarchitecture in patients with osteoporosis. Osteoporos Int 30:1655–1662PubMedCrossRef

27.

David V, Martin A, Isakova T et al (2016) Inflammation and functional iron deficiency regulate fibroblast growth factor 23 production. Kidney Int 89:135–146PubMedPubMedCentralCrossRef

28.

Hanudel MR, Chua K, Rappaport M et al (2016) Effects of dietary iron intake and chronic kidney disease on fibroblast growth factor 23 metabolism in wild-type and hepcidin knockout mice. Am J Physiol Renal Physiol 311:F1369–F1377PubMedPubMedCentralCrossRef

29.

Edmonston D, Wolf M (2020) FGF23 at the crossroads of phosphate, iron economy and erythropoiesis. Nat Rev Nephrol 16:7–19PubMedCrossRef

30.

Farrow EG, Yu X, Summers LJ et al (2011) Iron deficiency drives an autosomal dominant hypophosphatemic rickets (ADHR) phenotype in fibroblast growth factor-23 (Fgf23) knock-in mice. Proc Natl Acad Sci U S A 108:E1146-1155PubMedPubMedCentralCrossRef

31.

Hannemann A, Nauck M, Volzke H et al (2021) Interactions of anemia, FGF-23, and bone in healthy adults-results from the study of health in pomerania (SHIP). J Clin Endocrinol Metab 106:e288–e299PubMedCrossRef

32.

Imel EA, Peacock M, Gray AK et al (2011) Iron modifies plasma FGF23 differently in autosomal dominant hypophosphatemic rickets and healthy humans. J Clin Endocrinol Metab 96:3541–3549PubMedPubMedCentralCrossRef

33.

Katsumata S, Katsumata-Tsuboi R, Uehara M et al (2009) Severe iron deficiency decreases both bone formation and bone resorption in rats. J Nutr 139:238–243PubMedCrossRef

34.

Braithwaite V, Prentice AM, Doherty C et al (2012) FGF23 is correlated with iron status but not with inflammation and decreases after iron supplementation: a supplementation study. Int J Pediatr Endocrinol 2012:27PubMedPubMedCentralCrossRef

35.

Braithwaite V, Jarjou LM, Goldberg GR et al (2012) Iron status and fibroblast growth factor-23 in Gambian children. Bone 50:1351–1356PubMedPubMedCentralCrossRef

36.

Braithwaite V, Jones KS, Assar S et al (2014) Predictors of intact and C-terminal fibroblast growth factor 23 in Gambian children. Endocr Connect 3:1–10PubMedCrossRef

37.

Levey AS, Stevens LA, Schmid CH et al (2009) A new equation to estimate glomerular filtration rate. Ann Intern Med 150:604–612PubMedPubMedCentralCrossRef

38.

Pasquali M, Tartaglione L, Rotondi S et al (2015) Calcitriol/calcifediol ratio: an indicator of vitamin D hydroxylation efficiency? BBA clinical 3:251–256PubMedPubMedCentralCrossRef

39.

Wolf M, Koch TA, Bregman DB (2013) Effects of iron deficiency anemia and its treatment on fibroblast growth factor 23 and phosphate homeostasis in women. J Bone Miner Res 28:1793–1803PubMedCrossRef

40.

Lewerin C, Ljunggren O, Nilsson-Ehle H et al (2017) Low serum iron is associated with high serum intact FGF23 in elderly men: the Swedish MrOS study. Bone 98:1–8PubMedCrossRef

41.

Bozentowicz-Wikarek M, Kocelak P, Owczarek A et al (2015) Plasma fibroblast growth factor 23 concentration and iron status. Does the relationship exist in the elderly population? Clin Biochem 48:431–436PubMedCrossRef

42.

Ratsma DMA, Zillikens MC, van der Eerden BCJ (2021) Upstream regulators of fibroblast growth factor 23. Front Endocrinol 12:45CrossRef

43.

Sim JJ, Lac PT, Liu IL et al (2010) Vitamin D deficiency and anemia: a cross-sectional study. Ann Hematol 89:447–452PubMedCrossRef

Titel: A decrease in serum 1,25(OH)2D after elective hip replacement and during bone healing is associated with changes in serum iron and plasma FGF23
verfasst von: J. Vaculik
L. Wenchich
M. Bobelyak
K. Pavelka
J. J. Stepan
Publikationsdatum: 01.05.2022
Verlag: Springer International Publishing
Erschienen in: Journal of Endocrinological Investigation / Ausgabe 5/2022
Elektronische ISSN: 1720-8386
DOI: https://doi.org/10.1007/s40618-022-01746-1

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