- Simic, Petra;
- Kim, Wondong;
- Zhou, Wen;
- Pierce, Kerry A;
- Chang, Wenhan;
- Sykes, David B;
- Aziz, Najihah B;
- Elmariah, Sammy;
- Ngo, Debby;
- Pajevic, Paola Divieti;
- Govea, Nicolas;
- Kestenbaum, Bryan R;
- de Boer, Ian H;
- Cheng, Zhiqiang;
- Christov, Marta;
- Chun, Jerold;
- Leaf, David E;
- Waikar, Sushrut S;
- Tager, Andrew M;
- Gerszten, Robert E;
- Thadhani, Ravi I;
- Clish, Clary B;
- Jüppner, Harald;
- Wein, Marc N;
- Rhee, Eugene P
Fibroblast growth factor 23 (FGF23) is a bone-derived hormone that controls blood phosphate levels by increasing renal phosphate excretion and reducing 1,25-dihydroxyvitamin D3 [1,25(OH)2D] production. Disorders of FGF23 homeostasis are associated with significant morbidity and mortality, but a fundamental understanding of what regulates FGF23 production is lacking. Because the kidney is the major end organ of FGF23 action, we hypothesized that it releases a factor that regulates FGF23 synthesis. Using aptamer-based proteomics and liquid chromatography-mass spectrometry-based (LC-MS-based) metabolomics, we profiled more than 1600 molecules in renal venous plasma obtained from human subjects. Renal vein glycerol-3-phosphate (G-3-P) had the strongest correlation with circulating FGF23. In mice, exogenous G-3-P stimulated bone and bone marrow FGF23 production through local G-3-P acyltransferase-mediated (GPAT-mediated) lysophosphatidic acid (LPA) synthesis. Further, the stimulatory effect of G-3-P and LPA on FGF23 required LPA receptor 1 (LPAR1). Acute kidney injury (AKI), which increases FGF23 levels, rapidly increased circulating G-3-P in humans and mice, and the effect of AKI on FGF23 was abrogated by GPAT inhibition or Lpar1 deletion. Together, our findings establish a role for kidney-derived G-3-P in mineral metabolism and outline potential targets to modulate FGF23 production during kidney injury.