{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T18:02:16Z","timestamp":1791655336955,"version":"4.3.4"},"reference-count":54,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"crossref","award":["R01 DK072367"],"award-info":[{"award-number":["R01 DK072367"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"crossref","award":["R01 DK090070"],"award-info":[{"award-number":["R01 DK090070"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"crossref","award":["R01 HL172073"],"award-info":[{"award-number":["R01 HL172073"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"crossref","award":["R03 DK131246"],"award-info":[{"award-number":["R03 DK131246"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"crossref","award":["R01 DK132342"],"award-info":[{"award-number":["R01 DK132342"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"crossref","award":["R01DK131046"],"award-info":[{"award-number":["R01DK131046"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100006984","name":"Irma T. Hirschl Trust","doi-asserted-by":"crossref","award":["Irma T. Hirschl Career Scientist Award"],"award-info":[{"award-number":["Irma T. Hirschl Career Scientist Award"]}],"id":[{"id":"10.13039\/100006984","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Serum glycerol-3-phosphate (G3P) levels were significantly associated with higher fibroblast growth factor 23 levels in ESKD.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Pathway and mediation analyses identified the pentose phosphate pathway as the top mediator of the relationship between serum G3P and fibroblast growth factor 23.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>The role of G3P in ESKD provides new insights into potential therapeutic targets for CKD-mineral and bone disorder.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Fibroblast growth factor 23 (FGF23) is a key regulator of mineral metabolism that is independently associated with mortality in patients with ESKD. Glycerol-3-phosphate (G3P), a byproduct of glycolysis that can be derived from injured kidneys, stimulates FGF23 production. We aimed to determine if serum G3P is associated with FGF23 levels in patients with ESKD and identify potential molecular pathways that mediate their relationship.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a cross-sectional study of 99 nondiabetic patients with ESKD on hemodialysis. We used linear regression to examine the association between G3P terciles and log-transformed C-terminal FGF23 levels, adjusting for demographics, coronary artery disease, serum calcium, phosphorus, and parathyroid hormone. Mann\u2013Whitney\n                      <jats:italic toggle=\"yes\">U<\/jats:italic>\n                      tests compared 247 serum metabolite levels between the first and third FGF23 terciles; significant metabolites (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.01) were selected for pathway enrichment analyses. Top pathway scores were used in mediation analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median age of participants was 54 years (interquartile range [IQR], 44\u201363), 38% were women, 71% self-identified as Black, and 27% had coronary artery disease. The median FGF23 level was 777 (interquartile range, 222\u20131310) RU\/ml. In adjusted analyses, compared with participants with the lowest G3P tercile, those with the highest G3P tercile had a 95% higher FGF23 level (95% Confidence Interval, 6% to 260%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.04). Of the 27 metabolites significantly associated with FGF23 levels, pathway enrichment analysis identified the pentose phosphate pathway as the top hit (impact score=0.33, false discovery rate-adjusted\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      value = 0.01). The pentose phosphate pathway mediated the relationship between G3P and FGF23, resulting in a 62% change in the\n                      <jats:italic toggle=\"yes\">\u03b2<\/jats:italic>\n                      coefficient.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In nondiabetic patients with ESKD on hemodialysis, serum G3P positively correlated with serum C-terminal FGF23, and this relationship was mediated by the pentose phosphate pathway. Exploring the pentose phosphate pathway could yield critical mechanistic insights into the regulation of FGF23, enhancing our understanding of its broader biologic functions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2215\/cjn.0000000871","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T16:00:13Z","timestamp":1760716813000},"page":"211-220","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Association between Serum Glycerol-3-Phosphate and Fibroblast Growth Factor-23 in Nondiabetic Patients on Hemodialysis"],"prefix":"10.2215","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5436-5863","authenticated-orcid":false,"given":"Scott M.","family":"Wilson","sequence":"first","affiliation":[{"name":"Albert Einstein College of Medicine, Bronx, New York"},{"name":"Department of Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7075-467X","authenticated-orcid":false,"given":"Shari","family":"Zaslow","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0099-0484","authenticated-orcid":false,"given":"Stephen M.","family":"Sozio","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, Maryland"},{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1210-7115","authenticated-orcid":false,"given":"Bernard G.","family":"Jaar","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, Maryland"},{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7983-0127","authenticated-orcid":false,"given":"Farzana","family":"Perwad","sequence":"additional","affiliation":[{"name":"Division of Pediatric Nephrology, UCSF Benioff Children's Hospital, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4783-7046","authenticated-orcid":false,"given":"Cassiane","family":"Robinson-Cohen","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Vanderbilt University Medical Center, Nashville, Tennessee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8902-9576","authenticated-orcid":false,"given":"Michelle M.","family":"Estrella","sequence":"additional","affiliation":[{"name":"Kidney Health Research Collaborative, University of California San Francisco, San Francisco, California"},{"name":"San Francisco Veterans Affairs Health Care System, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0144-9294","authenticated-orcid":false,"given":"Aline","family":"Martin","sequence":"additional","affiliation":[{"name":"Northwestern University Feinberg School of Medicine, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6313-5752","authenticated-orcid":false,"given":"Rulan S.","family":"Parekh","sequence":"additional","affiliation":[{"name":"Women's College Hospital and Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1364-6102","authenticated-orcid":false,"given":"Wei","family":"Chen","sequence":"additional","affiliation":[{"name":"Nephrology Division, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York"},{"name":"Wilf Family Cardiovascular Research Institute, Albert Einstein College of Medicine, Bronx, New York"},{"name":"Department of Developmental and Molecular Biology, Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,10,17]]},"reference":[{"issue":"1","key":"B1-20260318","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1159\/000520466","article-title":"Causes of death in end-stage kidney disease: comparison between the United States renal data system and a large integrated health care 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