| Summary: | Aim of the work: This study aimed to investigate the plasma level of fibroblast growth factor-23 (FGF-23) in patients with primary knee osteoarthritis (KOA) and to elaborate its relation with radiographic and symptomatic severity of OA. Patients and methods: 50 KOA patients were recruited from the Rheumatology and Rehabilitation Department, Beni-Suef University Hospital and 20 matched controls were also included. Plasma FGF-23 level was estimated by ELISA. Severity of the disease was assessed clinically by Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score and radiologically by Kellgren-Lawrence (KL) grading scale. Results: The mean age of the patients was 59.8 ± 8.02 years (51–75 years) and disease duration 3.8 ± 2.1 years (1–9 years); they were 8 males (16%) and 42 (84%) females with a body mass index of 34.04 ± 5.3 (23.6–48.4). FGF-23 level was higher in KOA patients (96.2 ± 148.9 pg/ml; 3.4–14814.6 pg/ml) than in control (18.3 ± 11.1 pg/ml; 5–38.4 pg/ml) (p = .023). There was no significant difference in FGF-23 between males and females. FGF-23 was significantly increased in patients who had effusion (p = .004) or bilateral involvement (p = .023). Plasma FGF-23 level significantly correlated with disease severity sores; WOMAC and KL (p = .009, p = .01 respectively) and also with the age (p = .016), disease duration (p = .006) and body mass idex (p = .008) Conclusions: FGF-23 might be a potential biomarker for diagnosing and evaluating the onset and development of KOA and significantly correlated with the symptomatic and radiographic severity of the disease. Controlling KOA progression by inhibitors of FGF23 may be an issue of interest in further studies. Keywords: Fibroblast growth factor-23, Osteoarthritis, KL score, WOMAC score
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