Role of Circulating Fibroblast Growth Factor 21 Measurement in Primary Prevention of Coronary Heart Disease Among Chinese Patients With Type 2 Diabetes Mellitus

Lee, Chi H.; Woo, Yu Cho; Chow, Wing; Cheung, Chloe Yu Yan; Fong, Carol Ho Yi; Yuen, Mantak; Xu, Aimin; Tse, Hung‐Fat; Lam, Karen Siu Ling

doi:10.1161/jaha.116.005344

Cited by 33 publications

(29 citation statements)

References 38 publications

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“…Serum FGF21 levels were significantly increased in patients with insulin resistance and T2DM [ 21 ]. One recent study found that FGF21 level was an independent predictor of the raised incidence of CHD and may confer higher risks of CHD in T2DM subjects [ 22 ]. Elevated level of circulating FGF21 was correlated with the incidence of hypertension in community-dwelling adults [ 23 ] and dyslipidemia in CHD patients [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Circulating level of fibroblast growth factor 21 is independently associated with the risks of unstable angina pectoris

Cheng

Qiao

et al. 2018

Bioscience Reports

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There is increasing evidence that serum adipokine levels are associated with higher risks of cardiovascular diseases. As an important adipokine, fibroblast growth factor 21 (FGF21) has been demonstrated to be associated with atherosclerosis and coronary artery disease (CAD). However, circulating level of FGF21 in patients with angina pectoris has not yet been investigated. Circulating FGF21 level was examined in 197 patients with stable angina pectoris (SAP, n=66), unstable angina pectoris (UAP, n=76), and control subjects (n=55) along with clinical variables of cardiovascular risk factors. Serum FGF21 concentrations on admission were significantly increased more in patients with UAP than those with SAP (Ln-FGF21: 5.26 ± 0.87 compared with 4.85 ± 0.77, P<0.05) and control subjects (natural logarithm (Ln)-FGF21: 5.26 ± 0.87 compared with 4.54 ± 0.72, P<0.01). The correlation analysis revealed that serum FGF21 concentration was positively correlated with the levels of cardiac troponin I (cTnI) (r2 = 0.026, P=0.027) and creatine kinase-MB (CK-MB) (r2 = 0.023, P= 0.04). Furthermore, FGF21 level was identified as an independent factor associated with the risks of UAP (odds ratio (OR): 2.781; 95% CI: 1.476–5.239; P=0.002), after adjusting for gender, age, and body mass index (BMI). However, there were no correlations between serum FGF21 levels and the presence of SAP (OR: 1.248; 95% CI: 0.703–2.215; P=0.448). The present study indicates that FGF21 has a strong correlation and precise predictability for increased risks of UAP, that is independent of traditional risk factors of angina pectoris.

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Section: Discussionmentioning

confidence: 99%

Circulating level of fibroblast growth factor 21 is independently associated with the risks of unstable angina pectoris

Cheng

Qiao

et al. 2018

Bioscience Reports

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“…In the same cohort of subjects, higher serum FGF21 levels predicted development of major adverse cardiovascular events in 169 patients with CAD at baseline [30]. In another study of 3528 T2D patients, the optimal cut-off value of serum FGF21 levels at baseline was 206 pg/mL, levels above which predicted incident CHD over a median follow-up of 3.8 years [31]. In our previous study of 9697 T2D patients not on statin at baseline, higher plasma FGF21 levels predicted CVD events over 5 years follow-up [9].…”

Section: Discussionmentioning

confidence: 91%

High plasma FGF21 levels predicts major cardiovascular events in patients treated with atorvastatin (from the Treating to New Targets [TNT] Study)

et al. 2019

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Background: Higher plasma fibroblast growth factor 21 (FGF21) levels predict incident cardiovascular events in type 2 diabetes patients. However, whether FGF21 levels predict cardiovascular events in statin-treated patients in the general population is unknown. We investigated whether FGF21 levels predict major cardiovascular event (MCVE) in the Treating to New Targets (TNT) trial participants. Methods: After 8-week run-in on atorvastatin 10 mg/day, 10,001 patients with stable coronary disease in the TNT trial were randomized to 10 mg or 80 mg/day of atorvastatin for a median of 4.9 years. We analyzed data from 1996 patients with plasma FGF21 levels measured at randomization. Among them, 1835 patients had FGF21 measured one-year post-randomization. Results: Higher ln-transformed FGF21 levels at randomization were associated with higher risk of incident MCVE (adjusted hazards ratio per SD increase = 1.18, P = 0.019). At 1-year post-randomization, FGF21 levels were lower in patients randomized to receive 80 mg versus 10 mg atorvastatin (186.9 versus 207.5 pg/mL respectively, P = 0.006). Higher ln-transformed FGF21 levels at 1-year post-randomization were also associated with higher subsequent risk of MCVEs (adjusted hazards ratio per SD increase = 1.24, P = 0.009). However, changes in FGF21 levels over 1-year were not related to subsequent MCVE risk. FGF21 levels had significant incremental value in net reclassification improvement in MCVE risk prediction. Conclusions: Higher plasma FGF21 levels are associated with higher CVD risk in statin-treated high-risk patients. Higher dose atorvastatin is associated with a reduction in FGF21 levels. FGF21 provides incremental value in CVD risk prediction in statin-treated patients.

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“…Circulating FGF21 levels are recently viewed as an indicator of the development and progression of some chronic diseases 11,[33][34][35][36][37][38][39] . Furthermore, a negative relationship was found between circulating FGF21 levels and aerobic fitness in men 15,16) .…”

Section: Discussionmentioning

confidence: 99%

Association between circulating fibroblast growth factor 21, aerobic fitness, and aortic blood pressure in middle-aged and older women

Morimoto

Kosaki

Akazawa

et al. 2019

JPFSM

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Circulating fibroblast growth factor-21 (FGF21) has been reported to correlate with development and progression of some chronic diseases including diabetes and obesity. However, the association between circulating FGF21 levels, aerobic fitness, and aortic blood pressure (BP) is still not fully understood. This study aimed to examine potential association between circulating FGF21 levels, aerobic fitness, and aortic BP in 118 middle-aged and older women. Aortic pulse pressure (PP) in the higher FGF21 group was significantly increased when compared to the lower FGF21 group (38.4 ± 1.1 vs. 34.9 ± 0.8 mmHg; P < 0.05). Multivariate analysis found the circulating FGF21 level to be an independent determinant of aortic PP (β = 0.169; P < 0.05); and this finding was also independently determined by V ・ O2peak (β = −0.235; P < 0.01). Such a finding demonstrated that serum FGF21 levels were associated positively with aortic PP and negatively with aerobic fitness. These results have raised the possibility that FGF21 might contribute to an increase in aortic PP, and that the promotion of aerobic fitness might be effective in maintaining low FGF21 levels in middle-aged and older women.

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Role of Circulating Fibroblast Growth Factor 21 Measurement in Primary Prevention of Coronary Heart Disease Among Chinese Patients With Type 2 Diabetes Mellitus

Cited by 33 publications

References 38 publications

Circulating level of fibroblast growth factor 21 is independently associated with the risks of unstable angina pectoris

Circulating level of fibroblast growth factor 21 is independently associated with the risks of unstable angina pectoris

High plasma FGF21 levels predicts major cardiovascular events in patients treated with atorvastatin (from the Treating to New Targets [TNT] Study)

Association between circulating fibroblast growth factor 21, aerobic fitness, and aortic blood pressure in middle-aged and older women

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