Kwok Leung Ong1, Steven Campbell2, Ben J Wu3, Robyn L McClelland4, John Kokkinos3, Moyses Szklo5, Joseph F Polak6, Matthew A Allison7, Kerry-Anne Rye8. 1. Lipid Research Group, School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia; Sydney Medical School, University of Sydney, Sydney, NSW, Australia. Electronic address: oklws@yahoo.com.hk. 2. Sydney Medical School, University of Sydney, Sydney, NSW, Australia. 3. Lipid Research Group, School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia. 4. Department of Biostatistics, University of Washington, Seattle, WA, USA. 5. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. 6. Department of Radiology, Tufts University School of Medicine, Boston, MA, USA. 7. Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA. 8. Lipid Research Group, School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia; Sydney Medical School, University of Sydney, Sydney, NSW, Australia. Electronic address: k.rye@unsw.edu.au.
Abstract
BACKGROUND AND AIMS: Fibroblast growth factor 21 (FGF21) has been suggested as a novel biomarker for cardiovascular disease (CVD), especially in people with high CVD risk. However, it is not known whether FGF21 is a CVD biomarker in an initially healthy cohort. We therefore investigated the relationship of plasma FGF21 levels with measures of subclinical atherosclerosis and cardiovascular events in Multi-Ethnic Study of Atherosclerosis participants without known CVD at baseline. METHODS: A total of 5788 participants had plasma FGF21 levels measured at the baseline exam (2000-2002). Carotid intima-media thickness (IMT), ankle-brachial index (ABI) and coronary artery calcification (CAC) were measured at baseline. Participants were followed up for incident CVD events over a median period of 14 years. RESULTS: In cross-sectional analyses adjusting for socio-demographic variables, participants with higher FGF21 levels had higher carotid IMT, lower ABI, and higher prevalence of CAC (p < 0.001). However, these associations were not significant after simultaneously adjusting for demographic, socioeconomic and lifestyle factors, traditional CVD risk factors, and biomarkers of inflammation and hemostasis. Among 5768 patients with follow-up data, 820 developed incident CVD endpoints. Higher baseline FGF21 levels were not associated with the risk for incident CVD endpoints after adjusting for multiple confounding factors (odds ratio 1.03; 95% confidence interval, 0.94-1.12, per SD increase in ln-transformed FGF21 levels). CONCLUSIONS: Although FGF21 has been suggested as a CVD biomarker for people with high CVD risk, our findings do not support a role of FGF21 as a CVD biomarker in those without a history of CVD.
BACKGROUND AND AIMS: Fibroblast growth factor 21 (FGF21) has been suggested as a novel biomarker for cardiovascular disease (CVD), especially in people with high CVD risk. However, it is not known whether FGF21 is a CVD biomarker in an initially healthy cohort. We therefore investigated the relationship of plasma FGF21 levels with measures of subclinical atherosclerosis and cardiovascular events in Multi-Ethnic Study of Atherosclerosisparticipants without known CVD at baseline. METHODS: A total of 5788 participants had plasma FGF21 levels measured at the baseline exam (2000-2002). Carotid intima-media thickness (IMT), ankle-brachial index (ABI) and coronary artery calcification (CAC) were measured at baseline. Participants were followed up for incident CVD events over a median period of 14 years. RESULTS: In cross-sectional analyses adjusting for socio-demographic variables, participants with higher FGF21 levels had higher carotid IMT, lower ABI, and higher prevalence of CAC (p < 0.001). However, these associations were not significant after simultaneously adjusting for demographic, socioeconomic and lifestyle factors, traditional CVD risk factors, and biomarkers of inflammation and hemostasis. Among 5768 patients with follow-up data, 820 developed incident CVD endpoints. Higher baseline FGF21 levels were not associated with the risk for incident CVD endpoints after adjusting for multiple confounding factors (odds ratio 1.03; 95% confidence interval, 0.94-1.12, per SD increase in ln-transformed FGF21 levels). CONCLUSIONS: Although FGF21 has been suggested as a CVD biomarker for people with high CVD risk, our findings do not support a role of FGF21 as a CVD biomarker in those without a history of CVD.
Authors: Salah Sommakia; Naredos H Almaw; Sandra H Lee; Dinesh K A Ramadurai; Iosif Taleb; Christos P Kyriakopoulos; Chris J Stubben; Jing Ling; Robert A Campbell; Rami A Alharethi; William T Caine; Sutip Navankasattusas; Guillaume L Hoareau; Anu E Abraham; James C Fang; Craig H Selzman; Stavros G Drakos; Dipayan Chaudhuri Journal: Circ Heart Fail Date: 2021-12-06 Impact factor: 8.790