Multiple myeloma is the plasma cell malignancy in which bone involvement is common. The Fibroblast growth factor-23 (FGF-23)/Klotho pathway plays a major role in mineral metabolism that FGF-23 is mineralization inhibitory. Klotho also has anti-apoptotic and anti-tumor effects by acting as a tumor suppressor gene. There is a negative correlation between serum FGF-23 and serum soluble Klotho (sKL) levels. As such, there can be considerable interest in investigating sKL and FGF-23 as a biomarker in patients with MM. We used an enzyme-linked immunosorbent assay to measure serum FGF-23 and sKL levels in 55 newly diagnosed MM patients and 23 healthy controls. We determined significantly high serum FGF-23 and low serum sKL levels in MM patients when compared to healthy controls. Serum sKL levels correlated negatively with a p53 positive mutation status, with high ISS, elevated lactate dehydrogenase, C-reactive protein, Beta-2 microglobulin levels. Serum FGF-23 levels are associated negatively with serum phosphorus and positively only light chains and p53 mutation. Patients with high serum FGF-23 levels had significantly shorter median overall survival than those with low serum FGF-23 levels (p = 0.008). Additionally, low sKL levels were related to decreased overall survival, but they didn’t reach statistically significant (p = 0.072). There is a significant correlation between low serum sKL, high FGF-23 levels, and known prognostic factors in MM patients. We conclude that low sKL and high FGF-23 levels are a probable prognostic biomarker for poor MM patient outcomes.

多发性骨髓瘤是一种浆细胞恶性肿瘤，骨受累很常见。成纤维细胞生长因子 23 (FGF-23)/Klotho 途径在矿物质代谢中发挥重要作用，FGF-23 具有矿化抑制作用。Klotho 还作为抑癌基因具有抗凋亡和抗肿瘤作用。血清FGF-23与血清可溶性Klotho（sKL）水平呈负相关。因此，人们对研究 sKL 和 FGF-23 作为 MM 患者的生物标志物非常感兴趣。我们使用酶联免疫吸附测定法测量了 55 名新诊断的 MM 患者和 23 名健康对照者的血清 FGF-23 和 sKL 水平。与健康对照相比，我们确定 MM 患者的血清 FGF-23 水平显着升高，而血清 sKL 水平显着降低。血清 sKL 水平与 p53 阳性突变状态呈负相关，ISS 较高，乳酸脱氢酶、C 反应蛋白、Beta-2 微球蛋白水平升高。血清 FGF-23 水平与血清​​磷呈负相关，仅与轻链和 p53 突变呈正相关。血清 FGF-23 水平高的患者的中位总生存期显着短于血清 FGF-23 水平低的患者。p  = 0.008）。此外，低 sKL 水平与总体生存率降低有关，但并未达到统计学显着性 ( p  = 0.072)。MM 患者的低血清 sKL、高 FGF-23 水平和已知的预后因素之间存在显着相关性。我们得出的结论是，低 sKL 和高 FGF-23 水平可能是 MM 患者预后不良的预后生物标志物。