Endocrinology and Metabolism

Review Article

Mineral, Bone & Muscle
Acquired Forms of Fibroblast Growth Factor 23-Related Hypophosphatemic Osteomalacia: Nobuaki Ito, Naoko Hidaka, Hajime Kato; Endocrinol Metab. 2024;39(2):255-261. Published online March 11, 2024; DOI: https://doi.org/10.3803/EnM.2023.1908

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Fibroblast growth factor 23 (FGF23) is a pivotal humoral factor for the regulation of serum phosphate levels and was first identified in patients with autosomal dominant hypophosphatemic rickets and tumor-induced osteomalacia (TIO), the most common form of acquired FGF23-related hypophosphatemic rickets/osteomalacia (FGF23rHR). After the identification of FGF23, many other inherited and acquired forms of FGF23rHR were reported. In this review article, the detailed features of each acquired FGF23rHR are discussed, including TIO, ectopic FGF23 syndrome with malignancy, fibrous dysplasia/McCune-Albright syndrome, Schimmelpenning-Feuerstein-Mims syndrome/cutaneous skeletal hypophosphatemia syndrome, intravenous iron preparation-induced FGF23rHR, alcohol consumption-induced FGF23rHR, and post-kidney transplantation hypophosphatemia. Then, an approach for the differential diagnosis and therapeutic options for each disorder are concisely introduced. Currently, the majority of endocrinologists might only consider TIO when encountering patients with acquired FGF23rHR; an adequate differential diagnosis can reduce medical costs and invasive procedures such as positron emission tomography/computed tomography and venous sampling to identify FGF23-producing tumors. Furthermore, some acquired FGF23rHRs, such as intravenous iron preparation/alcohol consumption-induced FGF23rHR, require only cessation of drugs or alcohol to achieve full recovery from osteomalacia.

Citations

Citations to this article as recorded by

Paraneoplastic endocrine syndromes: a contemporary overview
Juan Eduardo Quiroz-Aldave, Jacsel Suarez-Rojas, Elman Rolando Gamarra-Osorio, Katia Rivera-Fabián, María Del Carmen Durand-Vásquez, Luis Alberto Concepción-Urteaga, José Paz-Ibarra, Marcio José Concepción-Zavaleta
Expert Review of Endocrinology & Metabolism.2025; 20(1): 51. CrossRef
Excess fibroblast growth factor 23 in alcoholic osteomalacia is derived from the bone
Naoko Hidaka, Yuko Oyama, Minae Koga, Naoki Kondo, Yoichi Yasunaga, Taketoshi Shimakura, Noriaki Yamamoto, Hideaki E Takahashi, Yoichi Iwafuchi, So Watanabe, Soichiro Kimura, Yoshitomo Hoshino, Hajime Kato, Yuka Kinoshita, Hiroshi Kobayashi, Takeyuki Tana
JBMR Plus.2025;[Epub] CrossRef
Acquired hypophosphatemic osteomalacia: case series from a Peruvian referral center (1999–2023)
José Paz-Ibarra, Sofía Sáenz-Bustamante, Manuel Inostroza-Fernández, Paola Sifuentes Hermenegildo, Liliana Ancajima Lescano, Marcio Concepción-Zavaleta, Alejandro Román-González, Alfredo Adolfo Reza-Albarrán
Archives of Osteoporosis.2024;[Epub] CrossRef

Original Article

Diabetes, Obesity and Metabolism Big Data Articles (National Health Insurance Service Database)
Association among Current Smoking, Alcohol Consumption, Regular Exercise, and Lower Extremity Amputation in Patients with Diabetic Foot: Nationwide Population-Based Study: Yoon Jae Lee, Kyung-Do Han, Jun Hyeok Kim; Endocrinol Metab. 2022;37(5):770-780. Published online October 12, 2022; DOI: https://doi.org/10.3803/EnM.2022.1519

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Abstract PDF PubReader ePub

Background
The present study investigates whether modifiable behavioral factors of current cigarette smoking, heavy alcohol consumption, and regular exercise are associated with risk of lower extremity amputation (LEA) in diabetic patients.
Methods
A total of 2,644,440 diabetic patients (aged ≥20 years) was analyzed using the database of the Korean National Health Insurance Service. Cox proportional hazard regression was used to assess adjusted hazard ratios (HRs) for the behavioral factors with risk of LEA under adjustment for potential confounders.
Results
The risk of LEA was significantly increased by current cigarette smoking and heavy alcohol consumption (HR, 1.436; 95% confidence interval [CI], 1.367 to 1.508 and HR, 1.082; 95% CI, 1.011 to 1.158) but significantly decreased with regular exercise (HR, 0.745; 95% CI, 0.706 to 0.786) after adjusting for age, sex, smoking, alcohol consumption, exercise, low income, hypertension, dyslipidemia, body mass index, using insulin or oral antidiabetic drugs, and diabetic duration. A synergistically increased risk of LEA was observed with larger number of risky behaviors.
Conclusion
Modification of behaviors of current smoking, heavy alcohol intake, and exercise prevents LEA and can improve physical, emotional, and social quality of life in diabetic patients.

Citations

Citations to this article as recorded by

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Vahide Semerci Çakmak, Serap Çetinkaya Özdemir
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Gyuri Kim, Seohyun Kim, You-Bin Lee, Sang-Man Jin, Kyu Yeon Hur, Jae Hyeon Kim
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Journal of Diabetes Research.2024;[Epub] CrossRef
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