It may therefore contribute to the risk of osteomalacia and negative association with markers of bone integrity and fracture risks, particularly in trabecular bone.(53, 54, 55) Whether an increase in FGF23 in response to vitamin D supplementation without a concomitant increase in plasma PTH and phosphate and decrease in 1,25(OH)2D is also associated with negative bone and CVD health outcomes needs further investigation. This evidence concerns the gene PTH and osteomalacia.