INS and Insulin resistance: They claimed that FGF-23 in circulation modulated the bonding of s-KL and thus indirectly affected insulin signal.20 Holecki et al. reported in their study on 3115 elderly individuals that there was no relationship between insulin resistance and FGF-23.21 Mirza et al. reported in The Prospective Investigation of the Vasculature in Uppsala Seniors Cohort (PIVUS) and The Osteoporotic Fractures in Men Study Cohort (MrOS) studies that one standard deviation increase in FGF-23 was associated with 8% and 12% higher insulin and HOMA-IR values.