And the fat lady sings about phosphate and calcium.

Adipose tissue has been long recognized as secreting various endocrine factors. Emerging evidence demonstrates that adipokines play a role in modulating systemic mineral homeostasis through endocrine loops involving interleukin-6, leptin, and now also adiponectin, which all interact with FGF23 and vitamin D and thereby change the renal control of calcium and phosphate metabolism. Understanding these regulatory loops may shed light on a complex interorgan crosstalk controlling mineral homeostasis and its dysregulation in diseases associated with obesity.