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Kidney Week

Abstract: TH-PO151

Association between Serum Glycerol-3-Phosphate and Fibroblast Growth Factor 23 in Nondiabetic Incident Hemodialysis Patients

Session Information

  • CKD-MBD: Clinical
    October 24, 2024 | Location: Exhibit Hall, Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Bone and Mineral Metabolism

  • 502 Bone and Mineral Metabolism: Clinical

Authors

  • Zaslow, Shari J., University of Vermont The Robert Larner MD College of Medicine, Burlington, Vermont, United States
  • Wilson, Scott Maxwell, Albert Einstein College of Medicine, Bronx, New York, United States
  • Sozio, Stephen M., Johns Hopkins University, Baltimore, Maryland, United States
  • Jaar, Bernard G., Johns Hopkins University, Baltimore, Maryland, United States
  • Estrella, Michelle M., University of California San Francisco, San Francisco, California, United States
  • Martin, Aline, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
  • Parekh, Rulan S., Women's College Hospital, Toronto, Ontario, Canada
  • Chen, Wei, Albert Einstein College of Medicine, Bronx, New York, United States
Background

Glycerol-3-phosphate (G3P), a byproduct of glycolysis that can be derived from injured kidneys, has been identified as a stimulator of fibroblast growth factor-23 (FGF-23) production. Furthermore, G3P is strongly correlated with circulating FGF-23 in people without kidney disease and in the setting of AKI. Since FGF-23 increases risk of mortality in patients with ESKD, understanding the relationship between G3P and FGF-23 may inform our diagnostic and treatment practices.

Methods

In a cross-sectional study of 99 nondiabetic patients with ESKD on incident hemodialysis from the Predictors of Arrhythmic and Cardiovascular Risk in End Stage Renal Disease (PACE) cohort, we measured baseline G3P by mass spectrometry and C-terminal FGF-23 by ELISA. Participant characteristics were compared among G3P terciles using the Fisher’s exact or Kruskal-Wallis’s tests. Linear regression was used to examine the association between G3P terciles with log transformed FGF-23 while adjusting for sociodemographics, prevalent coronary artery disease, phosphorus, and parathyroid hormone.

Results

The median age of participants was 54 years (IQR 44-63), 38% were women, 71% were Black, 27% had coronary artery disease. Median FGF-23 level was 777 (IQR 222-1310) RU/mL. Participants with higher G3P were younger and had higher levels of serum phosphate and intact parathyroid hormone. Higher G3P was associated with higher FGF-23 in both unadjusted and adjusted models (p<0.001 and 0.004, respectively). Those with G3P in the highest tercile had 92% higher level of FGF-23 (95% CI: 5%, 252%; p=0.004) compared to participants within the lowest G3P tertile.

Conclusion

Higher G3P is positively associated with higher FGF-23 in those with ESKD. Our findings suggest that there may be a kidney-independent role of G3P in FGF-23 regulation. Future studies will need to address the relationship between G3P and FGF-23 with earlier stages of CKD.

Funding

  • NIDDK Support