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

  • Nephrology - Original Paper
  • Published:
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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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Acknowledgements

This study was funded by the Grant CNCSIS for young research teams, Project No. PN-II-RU-TE-2014-4-1819

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Authors and Affiliations

  1. Department of Nephrology, University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj, 3-5 Clinicilor Street, 400006, Cluj-Napoca, Romania

    Crina Claudia Rusu, Ina Maria Kacso, Diana Moldovan, Alina Potra, Dacian Tirinescu, Dan Vladutiu & Mirela Gherman Caprioara

  2. Nefromed Dialysis Center, 40 Ana Aslan Street, Cluj-Napoca, Romania

    Simona Racasan, Cristian Budurea, Remus Orasan & Ioan Mihai Patiu

  3. Department of Informatics and Biostatistics, University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj, 6 Pasteur Street, 400349, Cluj-Napoca, Romania

    Cosmina Ioana Bondor

Authors
  1. Crina Claudia Rusu
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  2. Simona Racasan
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Correspondence to Crina Claudia Rusu.

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The authors declare that they have no conflict of interest. The results of this paper have not been published previously in whole or part.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Rusu, C.C., Racasan, S., Kacso, I.M. et al. The metabolic hormone FGF21 is associated with endothelial dysfunction in hemodialysis patients. Int Urol Nephrol 49, 517–523 (2017). https://doi.org/10.1007/s11255-016-1474-x

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