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2017 ; 12
(6
): e0178971
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Association between circulating fibroblast growth factor 21 and mortality in
end-stage renal disease
#MMPMID28582462
Kohara M
; Masuda T
; Shiizaki K
; Akimoto T
; Watanabe Y
; Honma S
; Sekiguchi C
; Miyazawa Y
; Kusano E
; Kanda Y
; Asano Y
; Kuro-O M
; Nagata D
PLoS One
2017[]; 12
(6
): e0178971
PMID28582462
show ga
Fibroblast growth factor 21 (FGF21) is an endocrine factor that regulates glucose
and lipid metabolism. Circulating FGF21 predicts cardiovascular events and
mortality in type 2 diabetes mellitus, including early-stage chronic kidney
disease, but its impact on clinical outcomes in end-stage renal disease (ESRD)
patients remains unclear. This study enrolled 90 ESRD patients receiving chronic
hemodialysis who were categorized into low- and high-FGF21 groups by the median
value. We investigated the association between circulating FGF21 levels and the
cardiovascular event and mortality during a median follow-up period of 64 months.
A Kaplan-Meier analysis showed that the mortality rate was significantly higher
in the high-FGF21 group than in the low-FGF21 group (28.3% vs. 9.1%, log-rank, P
= 0.034), while the rate of cardiovascular events did not significantly differ
between the two groups (30.4% vs. 22.7%, log-rank, P = 0.312). In multivariable
Cox models adjusted a high FGF21 level was an independent predictor of all-cause
mortality (hazard ratio: 3.98; 95% confidence interval: 1.39-14.27, P = 0.009).
Higher circulating FGF21 levels were associated with a high mortality rate, but
not cardiovascular events in patient with ESRD, suggesting that circulating FGF21
levels serve as a predictive marker for mortality in these subjects.
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