FGF23-Klotho axis in patients with rheumatoid arthritis

1, 2, 3, 4, 5, 6

  1. Department of Rheumatology, Hospital Vega-Baja, Alicante, Spain. antonioalvarezdc@gmail.com
  2. Department of Emergency, Hospital Santa Ana, Granada, Spain.
  3. Infectious Diseases Unit, Hospital General de Elche, Alicante, Spain.
  4. Institute of Parasitology and Biomedicine López-Neyra, IPBLN-CSIC, Granada, Spain.
  5. Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, IDIVAL, Santander, Spain. School of Medicine, University of Cantabria, Santander, Spain
  6. Systemic Autoimmune Diseases Unit, Hospital Universitario San Cecilio, Granada; School of Medicine, University of Granada, Instituto de Investigación Biosanitaria, IBS, Granada, Spain.

CER12042 Submission on line
2020 Vol.38, N°0 - PI 0050, PF 0057
Full Papers

Rheumatology Article



We aimed to compare serum Klotho and fibroblast growth factor-23 (FGF-23) levels between rheumatoid arthritis (RA) patients and healthy controls. Possible association between FGF-23 and soluble Klotho with different characteristic of the disease as well as their potential role as surrogate markers of cardiovascular disease (CVD) were studied.
Sixty-three patients with RA recruited at Vega-Baja Hospital, Orihuela (Spain) from November 2016 to May 2018 and sixty-five age- and sex-matched healthy controls were included in this study. Serum Klotho and FGF-23 were analysed using ELISA.
Patients had higher serum levels of Klotho than healthy controls (p˂0.0001). They were positively associated with the presence of anticitrullinated peptide antibody and rheumatic factor (p<0.05). Klotho serum levels were higher in RA patients treated with biologic agents than in those undergoing conventional therapy (p=0.008). However, no association with carotid intima media thickness was found. Although no significant differences in serum FGF-23 levels between patients and controls were found (p=0.43), FGF-23 levels were positively associated with low-density lipoprotein (LDL-c) level (p<0.05) and smoking (p=0.008) in patients with RA.
The increased serum Klotho levels in RA patients, especially in those undergoing biologic therapy, may indicate a potential implication in the pathogenesis of the disease. Although levels of FGF-23 were related to LDL-c levels, the FGF-23-Klotho axis does not seem to be related to subclinical arteriosclerosis in RA.

PMID: 31025926 [PubMed]

Received: 02/01/2019 - Accepted : 11/03/2019 - In Press: 16/04/2019 - Published: 06/02/2020