ECEESPE2025 Poster Presentations Bone and Mineral Metabolism (112 abstracts)
Obesity and blunted FGF23 response associate with kidney impairment in patients with hypoparathyroidism
Luigi di Filippo 1 , Agnese Allora 1 , Anna Maria Formenti 1 , Francesca Ferrari 1 , Marta Villanova 1 , Antonino Russo 2 , Barbara Presciuttini 3 , Massimo Locatelli 4 , Maria Luisa Brandi 1 , Giuseppe Vezzoli 5 , Claudio Marelli 6 & Andrea Giustina 1
1Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Milan, Italy; 2Internal Medicine Division, Santa Chiara Hospital, Provincial Health Care Agency (APSS), Trento, Italy; 3Endocrinology Unit, Medical Department, ASST Mantova, Mantua, Italy; 4Laboratory Medicine Service, IRCCS Ospedale San Raffaele, Milan, Italy; 5Unit of Nephrology and Dialysis, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Milan, Italy; 6Medical Pharma Consultant, Sestri Levante, Italy
JOINT983
Hypoparathyroidism is an endocrine disease characterized by low or insufficient parathyroid hormone secretion leading to alterations in calcium-phosphate and skeletal metabolism. Chronic kidney disease (CKD) is a common complication of patients affected by chronic hypoparathyroidism managed with conventional therapies. However, no data are currently available regarding the endocrine and metabolic determinants of renal function in these patients. This was a multicenter observational study performed in three health-care centres. Patients with hypoparathyroidism were consecutively enrolled during follow-up visits in 2022-2023. These exclusion criteria were adopted: patients managed with dialysis, proteinuria (>200 mg/24h), use of antihypertensive drugs including thiazides, ACE-inhibitors, angiotensin-II-receptor antagonists, alpha-beta blocking-agents, aldosterone-antagonists, and insulin-treated diabetes. A total of 46 patients were enrolled. Median age was 53 years, 34 (74%) were female and the median disease duration was 11 years. All patients were managed with conventional treatment with active vitamin D and calcium supplements, and the calcium-phosphate product was within the normal range in all patients. The 23. 7% of patients was obese (BMI ≥30 kg/m2) and CKD (defined with an eGFR<60 mL/min1. 73m2) was found in the 21. 7% of patients. Patients with CKD were older, affected by a longer-disease, and were more frequently obese (62% vs 13%, P = 0. 01) and characterized by a non-significant trend toward higher BMI (30. 4 vs 24. 1 kg/m2, P = 0. 07) as compared to those without. In multivariate analyses, obesity resulted as the only significant independent risk factor associated with CKD (P = 0. 035, OR 3. 05, CI 1. 38–6. 77). In addition, a significant negative correlation was found between BMI and eGFR (P = 0. 034; r= 0. 54), and ROC analyses showed a significant global-performances of BMI to predict CKD with the best youden index of 27. 5 kg/m2 (75% sensitivity, 74% specificity and AUROC 77%, P = 0. 008, CI 0. 42–0. 94). Patients with CKD were characterized also by higher FGF23 levels. A significant negative correlation was found between FGF23 and eGFR (P < 0. 001; r = 0. 78). However, evaluating separately patients with eGFR above and below 60 mL/min/1. 73m2, the correlation between FGF23 and eGFR remained statistically significant only in the first group (P = 0. 028; r = 0. 61) and not in those with CKD (P = 0. 7; r = 0. 22). In conclusion, for the first-time, obesity was demonstrated to be independently associated with CKD in patients with hypoparathyroidism, and a blunted eGFR-related response of FGF23 was shown in patients with CKD potentially worsening the renal function in the context of hypoparathyroidism.
Volume 110
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Endocrine Abstracts
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