الفهرس 
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Abstract
Summary
Osteoarthritis (OA) is the most frequent disease of the musculoskeletal system. The knee is one of the most common joint involved in OA (Naredo et al., 2005). OA is a leading cause of pain, disability and shortening of adult working life and its incidence increases with age. (Tonge et al., 2014).
It was shown thatFGF-23 produced by OA chondrocytes suggesting that it may play a role in the switch of OA chondrocytes towards hypertrophy (Bianchi et al., 2016).
This study aimed to investigate the serum levels of fibroblast growth factor-23 (FGF-23) of patients with knee osteoarthritis (OA) and to elaborate its correlation with radiographic and symptomatic severity of OA.
This study was conducted on 50 clinically diagnosed KOA patients and 20 healthy controls.
The patients were diagnosed according to the criteria of American College of Rheumatology (ACR) for diagnosis of KOA (Hochberg et al., 2012).
The KOA patients were and 42 females (84%)and8males(16%) their age ranged from 51 to 75 years with a mean of 59.48 + 8.02years , their disease duration ranged from 1to9 years with a mean of 3.78±2.1 years .
All patients and controls were subjected to:
• Full clinical history.
• BMI was calculated.
• General examination.
• Local examination: loco-motor examination of both lower limbs and lumbar vertebrae.
• Knee joint examination: gait examination, inspection, palpation and special test were done to knee joint.
Laboratory tests:
• Complete blood count (CBC), Erythrocyte sedimentation rate (ESR), C-reactive protien ,Rheumatoid factor ,Serum uric acid liver enzymes, Serum creatinine, Lipid profile,Rondom blood sugar and Urine analysis were performed for the exclusion of the secondary OA causes.
• Serum levels FGF-23 by ELISA technique.
• Plain X-ray for both knees was obtained and scored using Kellgren –Lawrence radiological score (K-L score).
The results obtained were statistically analyzed and summarized as follows:
• Serum FGF-23 levels are higher in knee OA patients than healthy subjects (P-value = 0.023).
• Serum FGF-23 levels were correlated positively with WOMAC score (P-value = 0.009).
• Serum FGF-23 levels were correlated positively with KL score (P-value = 0.011).
• Serum FGF-23 levels were correlated positively with age of the patients (P-value = 0.016) .
• Serum FGF-23 levels were correlated positively with disease duration (P-value = 0.006).
• Serum FGF-23 levels were correlated positively with BMI( P-value = 0.008).
• There was no significant difference in serum level of FGF-23 between males and females.
• Serum TAG, Cholesterol and VLDL are higher in KOA patients than healthy subjects (P-value = 0.008), (P-value = 0.03) and (P-value = 0.004) respectively.