Fibroblast growth factor 23 (FGF23) is a key regulator of phosphate metabolism. Circulating FGF23 levels are associated with obesity, metabolic syndrome, and cardiovascular disease in the general population, but the underlying mechanism remains unclear. Therefore, we aimed to determine the associations between serum FGF23 levels and visceral adiposity as well as serum adiponectin levels in 189 adults without diabetes and with normal kidney function who were selected from the MedCity21 health examination registry. The exclusion criteria included diabetes mellitus or impaired kidney function (estimated glomerular filtration rate [eGFR] <60 mL/min/1.73 m²). Levels of serum FGF23 and total adiponectin, and visceral fat area (VFA) on computed tomography images were measured. Serum FGF23 levels were higher and VFA was greater, whereas serum adiponectin levels were lower in men than in women. Serum FGF23 levels positively correlated with VFA in men; they remained marginally significant after adjusting for age, eGFR, and serum levels of calcium, phosphate, intact parathyroid hormone, and 1,25-dihydroxyvitamin D. Importantly, when serum adiponectin levels were included as a covariate, serum adiponectin levels comprised an independent determinant of serum FGF23 levels in men, whereas VFA did not. In conclusion, lower serum adiponectin, rather than a greater VFA, was associated with higher serum FGF23 levels in non-diabetic men with normal kidney function. These findings suggest that adiponectin plays a role in the relationship between visceral adiposity and FGF23 in men.

成纤维细胞生长因子 23 (FGF23) 是磷酸盐代谢的关键调节因子。循环 FGF23 水平与普通人群的肥胖、代谢综合征和心血管疾病有关，但其潜在机制仍不清楚。因此，我们旨在确定从 MedCity21 健康检查登记处选出的 189 名无糖尿病且肾功能正常的成年人的血清 FGF23 水平与内脏肥胖以及血清脂联素水平之间的关联。排除标准包括糖尿病或肾功能受损（估计肾小球滤过率 [eGFR] <60 mL/min/1.73 m ²）。测量了计算机断层扫描图像上血清 FGF23 和总脂联素以及内脏脂肪面积 (VFA) 的水平。血清 FGF23 水平较高，VFA 较高，而男性血清脂联素水平低于女性。男性血清 FGF23 水平与 VFA 呈正相关；在调整年龄、eGFR 和血清钙、磷酸盐、完整的甲状旁腺激素和 1,25-二羟基维生素 D 水平后，它们仍然略微显着。重要的是，当血清脂联素水平作为协变量包括在内时，血清脂联素水平是一个独立的决定因素男性血清 FGF23 水平的变化，而 VFA 没有。总之，在肾功能正常的非糖尿病男性中，较低的血清脂联素而非较高的 VFA 与较高的血清 FGF23 水平相关。