Relationship of fibroblast growth factor 21 with baseline and new on-study microvascular disease in the Fenofibrate Intervention and Event Lowering in Diabetes study

Abstract

Aims/hypothesis Baseline circulating fibroblast growth factor 21 (FGF21) levels can predict total cardiovascular disease events in the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study. This paper describes the relationship of baseline FGF21 levels and new on-study microvascular disease in patients with type 2 diabetes from the FIELD study. Methods Baseline FGF21 levels were measured in plasma by enzyme-linked immunosorbent assay in 9697 study participants. Total microvascular disease was defined as the presence of any nephropathy, retinopathy, neuropathy and/or microvascular amputation. The relationship between FGF21 levels and microvascular disease was assessed by multivariable logistic regression. Results Higher baseline FGF21 levels were found in patients with baseline total microvascular disease (p<0.001). The association remained significant after adjusting for potential confounding factors (OR [95% CI] 1.13 [1.08, 1.19] per SD increase in log e -transformed FGF21 levels, p<0.001). Of 6465 patients without baseline total microvascular disease, 1517 developed new on-study total microvascular disease over 5 years of follow-up. Higher baseline FGF21 levels were associated with a higher risk of new on-study total microvasKerry-Anne Rye and Anthony C. Keech are joint senior authors.Electronic supplementary material The online version of this article (doi:10.1007/s00125-015-3652-2) contains peer-reviewed but unedited supplementary material, which is available to authorised users.

The relationship of neutrophil elastase and proteinase 3 with risk factors, and chronic complications in type 2 diabetes: A Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) sub-study

“…[16][17][18][19][20][21][27][28][29] In this analysis, as specified for all FIELD biomarker analyses, the primary cardiovascular outcome was on-trial total CVD events which was a composite of coronary heart disease (CHD) events, total stroke and other cardiovascular death events plus coronary and carotid revascularisation. 28 The secondary cardiovascular outcomes in this analysis were the individual components of total CVD events, that is, CHD event, total stroke, CVD mortality and coronary and carotid revascularisation. In this study, we also analysed the tertiary outcome of hospital admission for angina pectoris which included unstable angina, other forms of angina pectoris and unspecified angina pectoris with matched codes of I20.0, I20.8 and I20.9 by ICD-10 (International Classification of Diseases, Tenth Revision).…”

Association between serum fibroblast growth factor 21 level and sight-threatening diabetic retinopathy in Chinese patients with type 2 diabetes

“…However, when those with microvascular disease were separately studied, serum FGF21 level was only correlated to nephropathy, and it had no association with retinopathy or other microvascular diseases. 20 A number of scholars further studied the relationship between serum FGF21 level and DR, and found that cases with DR had a significantly higher serum FGF21 level than those without DR. 17 21 Jung et al reported a different U-shaped relationship between serum FGF21 level and prevalence of DR. 22 This discrepancy might result from the difference in patients' characteristics, such as age, blood glucose level, lipoprotein level and so on. Numerous researches pointed out that the mentioned discrepancy might be related to a relatively small sample size.…”

Fibroblast growth factor 21 – a key player in cardiovascular disorders?

“…It has been reported that higher baseline plasma FGF21 levels predict CV events in DM2 patients. Furthermore, Ong et al also found that higher baseline FGF21 levels established microvascular disease, and predicted the future development of new microvascular disease in a population of the FIELD study [19].…”