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Serum FGF23 is correlated with outcomes in several diseases. Fasting stimulates the production of ketone bodies. We hypothesized that fasting can induce FGF23 synthesis through the production of ketone bodies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>UMR106 cells and isolated neonatal rat ventricular myocytes (NRVM) were treated with ketone body \u03b2\u2010hydroxybutyrate. Mice were fasted overnight, fed ad libitum, or treated with \u03b2\u2010hydroxybutyrate. Proteins and further blood parameters were determined by enzyme\u2010linked immunoassay (ELISA), western blotting, immunohistochemistry, fluorometric or colorimetric methods, and gene expression by quantitative real\u2010time polymerase chain reaction (qRT\u2010PCR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>\u03b2\u2010Hydroxybutyrate stimulated FGF23 production in UMR106 cells in a nuclear factor kappa\u2010light\u2010chain enhancer of activated B\u2010cells (NF\u03baB)\u2010dependent manner, and in NRVMs. Compared to fed animals, fasted mice exhibited higher \u03b2\u2010hydroxybutyrate and FGF23 serum levels (based on assays either detecting C\u2010terminal or intact, biologically active FGF23 only), cardiac, pancreatic, and thymic <jats:italic>Fgf23<\/jats:italic> and renal <jats:italic>Cyp24a1<\/jats:italic> expression, and lower 1,25(OH)<jats:sub>2<\/jats:sub>D<jats:sub>3<\/jats:sub> serum concentration as well as renal <jats:italic>Slc34a1<\/jats:italic> and \u03b1Klotho (<jats:italic>Kl<\/jats:italic>) expression. In contrast, <jats:italic>Fgf23<\/jats:italic> expression in bone and serum phosphate, calcium, plasma parathyroid hormone (PTH) concentration, and renal <jats:italic>Cyp27b1<\/jats:italic> expression were not significantly affected by fasting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Short\u2010term fasting increased FGF23 production, as did administration of \u03b2\u2010hydroxybutyrate, effects possibly of clinical relevance in view of the increasing use of FGF23 as a surrogate parameter in clinical monitoring of diseases. The fasting state of patients might therefore affect FGF23 tests.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apha.14049","type":"journal-article","created":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T10:10:34Z","timestamp":1695636634000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Short\u2010term fasting of mice elevates circulating fibroblast growth factor 23 (<scp>FGF23<\/scp>)"],"prefix":"10.1111","volume":"239","author":[{"given":"Martina","family":"Feger","sequence":"first","affiliation":[{"name":"Department of Physiology University of Hohenheim  Stuttgart Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jana","family":"Alber","sequence":"additional","affiliation":[{"name":"Department of Physiology University of Hohenheim  Stuttgart 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