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International Urology and Nephrology
Published in: International Urology and Nephrology 3/2017

01-03-2017 | Nephrology - Original Paper

The metabolic hormone FGF21 is associated with endothelial dysfunction in hemodialysis patients

Authors: Crina Claudia Rusu, Simona Racasan, Ina Maria Kacso, Diana Moldovan, Alina Potra, Dacian Tirinescu, Cristian Budurea, Remus Orasan, Ioan Mihai Patiu, Cosmina Ioana Bondor, Dan Vladutiu, Mirela Gherman Caprioara

Published in: International Urology and Nephrology | Issue 3/2017

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Abstract

Purpose

Finding new, reliable biomarkers of cardiovascular risk in hemodialysis (HD) patients is of utmost importance. Fibroblast growth factor 21 (FGF21) has been recently associated with atherosclerosis in the general population. The relationship between markedly elevated FGF21 levels in HD patients and endothelial dysfunction is unknown. The aim of the study was to assess the determinants of FGF21, the correlation between FGF21 and tumor necrosis factor TNF-like weak inducer of apoptosis (sTWEAK) and the correlation between FGF21 and endothelial dysfunction in HD patients.

Methods

A cross-sectional observational study was conducted in 70 HD patients (mean age 59.9 ± 12.5 years, 14.3% diabetes mellitus, 57.1% male) from Nefromed Dialysis Center Cluj. We registered clinical and biological data, and serum FGF21 levels were measured by ELISA. Endothelial function was evaluated by brachial flow-mediated dilation (FMD). An analysis based on stratification of FGF21 values into quartiles was performed.

Results

FGF21 levels were directly correlated with sTWEAK, tricipital skinfold thickness (TST), systolic blood pressure (SBP), total cholesterol and triglycerides. In multivariate linear analysis, only sTWEAK and SBP remained significantly associated with FGF21. FGF21 values in the inferior quartile were directly correlated with HDL-cholesterol, while FGF21 values in the superior quartile were directly correlated with SBP, pulse pressure and sTWEAK. FMD was significantly higher in the inferior quartile as compared to the superior quartile.

Conclusions

High FGF21 values in our patients are correlated with atherosclerosis risk factors: hypercholesterolemia, hypertriglyceridemia, hypertension, increased TST and increased levels of sTWEAK. Endothelial dysfunction is associated with high FGF21 in HD patients.
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Metadata
Title
The metabolic hormone FGF21 is associated with endothelial dysfunction in hemodialysis patients
Authors
Crina Claudia Rusu
Simona Racasan
Ina Maria Kacso
Diana Moldovan
Alina Potra
Dacian Tirinescu
Cristian Budurea
Remus Orasan
Ioan Mihai Patiu
Cosmina Ioana Bondor
Dan Vladutiu
Mirela Gherman Caprioara
Publication date
01-03-2017
Publisher
Springer Netherlands
Published in
International Urology and Nephrology / Issue 3/2017
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-016-1474-x

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