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Trial record 4 of 73 for:    Paraneoplastic Syndromes

Observing the Changes of Fibroblast Growth Factor 23 in Patients of Tumor Induced Osteomalacia

This study is currently recruiting participants.
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Verified July 2016 by National Taiwan University Hospital
Information provided by (Responsible Party):
National Taiwan University Hospital Identifier:
First received: August 5, 2012
Last updated: July 4, 2016
Last verified: July 2016

Fibroblast froth factors (FGFs) are humoral factors identified by their ability to stimulate cell proliferation1. They play different roles in the regulation of cell proliferation, differentiation and function. Most FGF family members act as paracrine factors. But FGF19(FGF19) subfamily members, including FGF19, 21, and 23, work as endocrine factors to regulate bile acid, carbohydrate and phosphate metabolism2. Of these, FGF23 plays an important role in phosphate and bone metabolism3. FGF23 gene encodes 251 amino acids, including a 24-amino acid signal peptide4. The secreted FGF23 is a protein consisted of 227 amino acids. It works by binding to a Klotho-FGF receptor 1c (FGF1c) complex5. FGF suppresses the expression of type 2a and 2c sodium-phosphate cotransporters, which mediate phosphate reabsorption in proximal tubules.6 FGF23 decreases 25-hydroxyvitamin D-1α-hydroxylase expression and enhances 25-hydroxyvitamin D-24-hydroxylase expression6. Therefore, FGF23 reduces serum 1,25-dihydroxyvitamin D〔1,25(OH)2D〕, which stimulates intestinal calcium and phosphate absorption. FGF23 decreases serum phosphate through the above mechanisms FGF23 over-expression might result in hypophosphatemic rickets and osteomalacia.

Tumor induced osteomalacia (TIO) is a paraneoplastic syndrome usually caused by benign phosphaturic mesenchymal tumors. Symptoms are nonspecific, such as general weakness, fatigue, and bone pain. Sometimes fracture may occurs. The responsible tumors are sometimes small and difficult to detect. Tumors secrete FGF23. FGF23 reduced phosphate reabsorption in the proximal tubules and decrease 1,25(OH)2D levels, which result in hypophosphatemia and then osteomalacia.

The investigators would like to observe the changes of FGF23 in patients who receive operation or medical treatment and hope this will benefit future treatment.


Study Type: Observational
Study Design: Observational Model: Case Control
Time Perspective: Prospective
Official Title: Observing the Changes of Fibroblast Growth Factor 23 in Patients of Tumor Induced Osteomalacia

Resource links provided by NLM:

Further study details as provided by National Taiwan University Hospital:

Primary Outcome Measures:
  • FGF23, P [ Time Frame: at the time TIO is diagnosed ]

Estimated Enrollment: 40
Study Start Date: June 2011
Estimated Study Completion Date: August 2016
Estimated Primary Completion Date: August 2016 (Final data collection date for primary outcome measure)
Tumor induced osteomalcia


Ages Eligible for Study:   20 Years to 85 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population
Patients with tumor induced osteomalacia and people without osteomalacia

Inclusion Criteria:

  • patients with tumor induced osteomalacia.
  • people without osteomalacia such as healthy people,
  • people under dialysis,
  • people with poor nutrition.

Exclusion Criteria:

  • people younger than 20 years old or older than 85 years old.
  • people who are pregnant.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT01660308

Contact: Shyang-Rong Shih, PhD

National Taiwan University Hospital Recruiting
Taipei, Taiwan
Contact: Shyang-Rong Shih, PhD    886-972653337   
Principal Investigator: Shyang-Rong Shih, PhD         
Sponsors and Collaborators
National Taiwan University Hospital
Principal Investigator: Shyang-Rong Shih, PhD National Taiwan University Hospital
  More Information

Publications automatically indexed to this study by Identifier (NCT Number):
Responsible Party: National Taiwan University Hospital Identifier: NCT01660308     History of Changes
Other Study ID Numbers: 201105045RC
Study First Received: August 5, 2012
Last Updated: July 4, 2016

Additional relevant MeSH terms:
Neoplasms, Connective Tissue
Phosphorus Metabolism Disorders
Metabolic Diseases
Bone Diseases, Metabolic
Bone Diseases
Musculoskeletal Diseases
Calcium Metabolism Disorders
Vitamin D Deficiency
Deficiency Diseases
Nutrition Disorders
Neoplasms, Connective and Soft Tissue
Neoplasms by Histologic Type
Connective Tissue Diseases
Mitosis Modulators
Molecular Mechanisms of Pharmacological Action processed this record on August 16, 2017