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Magdaléna Fořtová Department of Medical Chemistry and Clinical Biochemistry, Charles University, Second Faculty of Medicine and University Hospital Motol, Prague, Czech Republic

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Lenka Hanousková Department of Medical Chemistry and Clinical Biochemistry, Charles University, Second Faculty of Medicine and University Hospital Motol, Prague, Czech Republic

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Martin Valkus Department of Medical Chemistry and Clinical Biochemistry, Charles University, Second Faculty of Medicine and University Hospital Motol, Prague, Czech Republic

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Jana Čepová Department of Medical Chemistry and Clinical Biochemistry, Charles University, Second Faculty of Medicine and University Hospital Motol, Prague, Czech Republic

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Richard Průša Department of Medical Chemistry and Clinical Biochemistry, Charles University, Second Faculty of Medicine and University Hospital Motol, Prague, Czech Republic

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Karel Kotaška Department of Medical Chemistry and Clinical Biochemistry, Charles University, Second Faculty of Medicine and University Hospital Motol, Prague, Czech Republic

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frequently used indicator of successful parathyroidectomy; nevertheless, the information about changes of fibroblast growth factor 23 (FGF23) levels is scarce ( 2 , 3 ). FGF23 is a phosphaturic peptide promoting phosphate excretion in urine. It is a member

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Shu-Meng Hu Department of Nephrology, West China Hospital, Sichuan University, Chengdu, Sichuan, China

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Yang-Juan Bai Department of Laboratory Medicine/Research Centre of Clinical Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China

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Ya-Mei Li Department of Laboratory Medicine/Research Centre of Clinical Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China

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Ye Tao Department of Nephrology, West China Hospital, Sichuan University, Chengdu, Sichuan, China

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Xian-Ding Wang Department of Urology/Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China

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Tao Lin Department of Urology/Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China

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Lan-Lan Wang Department of Laboratory Medicine/Research Centre of Clinical Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China

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Yun-Ying Shi Department of Nephrology, West China Hospital, Sichuan University, Chengdu, Sichuan, China

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closely associated with bone fracture, graft loss, cardiovascular events and all-cause death after KT ( 2 , 3 , 4 ). Fibroblast growth factor 23 (FGF23) is a phosphaturic hormone produced by osteocytes and osteoblasts. By binding to FGF receptor 1

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Anru Wang Department of Pediatrics, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Department of Pediatrics, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China

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Xueqin Yan Department of Pediatrics, Boai Hospital of Zhongshan, Zhongshan, China

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Cai Zhang Department of Pediatrics, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

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Caiqi Du Department of Pediatrics, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

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Wenjun Long Department of Pediatrics, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

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Di Zhan Department of Pediatrics, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

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Xiaoping Luo Department of Pediatrics, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

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. Recent clinical and animal studies have reported that FGF19 and FGF21 are associated with obesity and T2DM ( 2 , 3 ). FGF19 and FGF21 suppress triglyceride and glucose syntheses, meanwhile inducing glycogenesis and fatty acid oxidation in the liver

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Vickie Braithwaite Medical Research Council (MRC) Human Nutrition Research, MRC Keneba, Elsie Widdowson Laboratories, Fulbourn Road, Cambridge CB1 9NL, UK

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Kerry S Jones Medical Research Council (MRC) Human Nutrition Research, MRC Keneba, Elsie Widdowson Laboratories, Fulbourn Road, Cambridge CB1 9NL, UK
Medical Research Council (MRC) Human Nutrition Research, MRC Keneba, Elsie Widdowson Laboratories, Fulbourn Road, Cambridge CB1 9NL, UK

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Shima Assar Medical Research Council (MRC) Human Nutrition Research, MRC Keneba, Elsie Widdowson Laboratories, Fulbourn Road, Cambridge CB1 9NL, UK

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Inez Schoenmakers Medical Research Council (MRC) Human Nutrition Research, MRC Keneba, Elsie Widdowson Laboratories, Fulbourn Road, Cambridge CB1 9NL, UK

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Ann Prentice Medical Research Council (MRC) Human Nutrition Research, MRC Keneba, Elsie Widdowson Laboratories, Fulbourn Road, Cambridge CB1 9NL, UK
Medical Research Council (MRC) Human Nutrition Research, MRC Keneba, Elsie Widdowson Laboratories, Fulbourn Road, Cambridge CB1 9NL, UK

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Introduction Elevated plasma C-terminal fibroblast growth factor 23 (C-FGF23) concentrations have been recorded in Gambian children with putative Ca-deficiency rickets (1) and, at a lower prevalence, in apparently healthy children from the local

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Carlijn A Hoekx Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands
Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands

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Borja Martinez-Tellez Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands
Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
Department of Nursing Physiotherapy and Medicine, SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
Biomedical Research Unit, Torrecárdenas University Hospital, Almería, Spain
CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Granada, Spain

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Maaike E Straat Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands
Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands

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Magdalena M A Verkleij Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands
Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands

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Mirjam Kemmeren Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands
Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands

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Sander Kooijman Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands
Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands

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Martin Uhrbom Bioscience Metabolism, Research and Early Development, Cardiovascular, Renal and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZeneca Gothenburg, Sweden
Department of Medicine, Huddinge, Karolinska Institutet Campus Flemingsberg, Neo Building, Huddinge, Sweden

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Saskia C A de Jager Laboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands

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Patrick C N Rensen Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands
Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands

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Mariëtte R Boon Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands
Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands

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that could enhance energy metabolism ( 15 ). Preclinical experiments have identified two batokines that have a prominent effect on energy balance: fibroblast growth factor 21 (FGF21) and growth differentiation factor 15 (GDF15) ( 16 , 17 ). FGF21, when

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Xiaoli Liu Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, China

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Lanxiang Liu Department of Medical Imaging, The First Hospital of Qinhuangdao, Qinhuangdao, China

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Rui Wang Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, China

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Xiaojiao Jia Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, China

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Binbin Liu Department of Functional Examination, The First Hospital of Qinhuangdao, Qinhuangdao, China

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Ning Ma Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, China

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Qiang Lu Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, China

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atherosclerosis. It is an accurate, reliable, and noninvasive detection index for the early diagnosis of peripheral arterial diseases ( 6 , 7 ). Fibroblast growth factor 21 (FGF21) is a metabolic regulator that has multiple functions, such as reducing blood

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Peiwen Zheng School of Mental Health, Wenzhou Medical University, The Affiliated Kangning Hospital, Wenzhou, China

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Fan Wang Beijing Hui-Long-Guan Hospital, Peking University, Beijing, China

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Hui Li Psychosomatic Medicine Research Division, Inner Mongolia Medical University, Huhhot, China

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Hanlu Chen School of Mental Health, Wenzhou Medical University, The Affiliated Kangning Hospital, Wenzhou, China

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Mengtong Li School of Mental Health, Wenzhou Medical University, The Affiliated Kangning Hospital, Wenzhou, China

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Haozheng Ma School of Mental Health, Wenzhou Medical University, The Affiliated Kangning Hospital, Wenzhou, China

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Jue He School of Mental Health, Wenzhou Medical University, The Affiliated Kangning Hospital, Wenzhou, China

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Li Chen School of Mental Health, Wenzhou Medical University, The Affiliated Kangning Hospital, Wenzhou, China

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Yanlong Liu School of Mental Health, Wenzhou Medical University, The Affiliated Kangning Hospital, Wenzhou, China

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Haiyun Xu School of Mental Health, Wenzhou Medical University, The Affiliated Kangning Hospital, Wenzhou, China

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levels of fibroblast growth factor 21 (FGF21), zinc, Cu, and iron in CSF. FGF21 is a metabolic cytokine involved in a plethora of tissue-specific effects (23, 24 , 25 , 26 ). Intracellular Zn 2+ plays an important role in mitochondrial function under

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Amalie R Lanng Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark

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Lærke S Gasbjerg Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Natasha C Bergmann Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark

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Sigrid Bergmann Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark

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Mads M Helsted Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark

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Matthew P Gillum Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Bolette Hartmann Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Jens J Holst Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Tina Vilsbøll Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
Steno Diabetes Center Copenhagen, Gentofte, Denmark
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Filip K Knop Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Steno Diabetes Center Copenhagen, Gentofte, Denmark
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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constitute a potent stimulator of the liver-derived hormone fibroblast growth factor 21 (FGF21) in humans ( 13 , 14 ). In rodents, FGF21 has been shown to increase insulin sensitivity ( 15 ) and decrease hepatic glucose production, and thus, play an

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Raja Padidela Royal Manchester Children’s Hospital and Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK

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Moira S Cheung Evelina London Children’s Hospital, London, UK

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Vrinda Saraff Birmingham Women’s and Children’s Hospital, Birmingham, UK

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Poonam Dharmaraj Alder Hey Children’s NHS Foundation Trust, Liverpool, UK

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variant in the PHEX gene, as a result of which serum FGF23 levels are elevated, resulting in hypophosphataemia. Low serum phosphate reduces hydroxyapatite formation causing osteomalacia and leads to the failure of apoptosis of hypertrophied

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Huma Qamar Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada

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Nandita Perumal Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada

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Eszter Papp Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada

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Alison D Gernand Department of Nutritional Sciences, Pennsylvania State University, University Park, Pennsylvania, USA

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Abdullah Al Mahmud Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh

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Daniel E Roth Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
Department of Paediatrics, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada

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calcium-sensing receptor ( 25 ). Fibroblast-like growth factor-23 (FGF23), a marker of bone metabolism, has also been postulated as a regulator of PTH secretion, although the direction of this effect is not yet well characterized ( 26 , 27 , 28 , 29

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