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82?pg/mL (range 4.2 to 111.1?pg/mL). There was no difference in the risk of incident nonspine, hip, major osteoporotic, or incident vertebral fractures by quartile of FGF23 (Table 2) in base models adjusted for age, BMI, race, and clinic site. Further adjustment for BMD, vitamin D, PTH, walking speed, alcohol use, fracture history, and serum phosphorus did not change the results significantly. In addition, there were no associations among those with the highest FGF23 level compared with the lower FGF23 levels with nonspine fractures (base model, Q4 versus Q1, 2, 3: HR?=?1.1; 95% CI 0.85�C1.43). Similarly, no associations were found among the other fracture types with FGF23. To determine if men with poor renal function and high FGF23 have an increased risk of fracture, we stratified men into two strata: eGFRCrCysC 60?mL/min/1.73?m2. There were 73 nonspine fractures (33 in the Q4 of FGF23) among 313 men with eGFRCrCysC 60. There were 22 men (9 nonspine fractures) who had missing creatinine measures and hence were not included in these analyses. We observed a twofold increased risk of nonspine fractures in the highest quartile of FGF23 compared with the rest among men with low eGFR (HR?=?2.25; 95% CI 1.26�C4) in base models (Table 3). Further adjustment for hip BMD, vitamin D, PTH, alcohol use, walking speed, fracture history, and serum phosphorus did not change the results significantly (HR?=?2.02; 95% CI 1.07�C3.79). In contrast, among men with eGFRCrCysC >60, there was no association between FGF23 and nonspine fracture (base model: HR?=?0.94; 95% CI 0.69�C1.27) (Table 3). Adjusting for eGFR in the stratified analysis did not change the results significantly. Stratified analysis by eGFR strata was limited and not conducted because of the small numbers of fractures within the