Abstract
Background Fibroblast growth factor 21 (FGF-21) is a hormone that regulates glucose and lipid metabolism. High serum FGF-21 levels are associated with carotid atherosclerosis and coronary artery disease. This cross-sectional study aimed to assess the relationship between serum FGF-21 levels and carotid-femoral pulse wave velocity (cfPWV) in patients on maintenance hemodialysis (HD). Methods Blood samples and baseline characteristics were collected from 130 HD patients. Serum FGF-21 concentrations were measured with an enzyme-linked immunosorbent assay kit. Aortic stiffness was defined as a carotid-femoral pulse wave velocity (cfPWV) of more than 10 m/s. Results Of the 130 HD patients, aortic stiffness was diagnosed in 54 (41.5%). Serum FGF-21 levels were significantly higher in those with aortic stiffness than those without (P < 0.001). The FGF-21 level was independently associated with aortic stiffness (odds ratio (OR): 1.008; 95% CI: 1.003–1.012; P=0.001) after adjusting for diabetes mellitus, age, hypertension, C-reactive protein, and body weight in multivariable logistic regression analysis. Multivariable forward stepwise linear regression analysis also confirmed that the logarithmically transformed FGF-21 level (β = 3.245, 95% CI: 1.593–4.987, P < 0.001) was an independent predictor of cfPWV values. The area under the receiver operating characteristic (ROC) curve predicting aortic stiffness by the serum FGF-21 level was 0.693 (95% CI: 0.606–0.771, P < 0.001). Conclusions Serum FGF-21 level positively correlates with cfPWV and is also an independent predictor of aortic stiffness in maintenance HD patients.
Highlights
Cardiovascular disease contributes to nearly half of deaths in patients with end-stage renal disease (ESRD) [1]
Fibroblast growth factor 21 (FGF-21) is a predominantly liver-derived hormone involved in regulating glucose and lipid metabolism, acting as a downstream target of peroxisome proliferator-activated receptor (PPAR) α and PPARc
A total of 130 subjects, including 76 patients with a normal carotid-femoral pulse wave velocity (cfPWV) (53.9% females, mean age 61.8 ± 13.7 years) and 54 subjects with an increased cfPWV (42.6% females, mean age 66.7 ± 12.0 years), were included. e etiologies of ESRD were diabetic nephropathy in 49 patients (37.7%), glomerulonephritis in 54 patients (41.5%), hypertensive nephropathy in 6 patients (4.6%), and other causes in 21 patients (16.2%). ere were no differences in gender, HD duration, body mass index (BMI) in the obese or overweight range, history of smoking, Kt/V, diastolic blood pressure, and the use of antihypertensive or antihyperlipidemic therapy between the two groups. e blood urea nitrogen, creatinine, total cholesterol, triglycerides, fasting glucose, total calcium, phosphorus, and intact parathyroid hormone (iPTH) levels were similar between the two Overall (n 130)
Summary
Fibroblast growth factor 21 (FGF-21) is a hormone that regulates glucose and lipid metabolism. Is cross-sectional study aimed to assess the relationship between serum FGF-21 levels and carotid-femoral pulse wave velocity (cfPWV) in patients on maintenance hemodialysis (HD). Aortic stiffness was defined as a carotid-femoral pulse wave velocity (cfPWV) of more than 10 m/s. E FGF-21 level was independently associated with aortic stiffness (odds ratio (OR): 1.008; 95% CI: 1.003–1.012; P 0.001) after adjusting for diabetes mellitus, age, hypertension, C-reactive protein, and body weight in multivariable logistic regression analysis. Multivariable forward stepwise linear regression analysis confirmed that the logarithmically transformed FGF-21 level (β 3.245, 95% CI: 1.593–4.987, P < 0.001) was an independent predictor of cfPWV values. Serum FGF-21 level positively correlates with cfPWV and is an independent predictor of aortic stiffness in maintenance HD patients
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