Serum fibroblast growth factor-21 concentration is associated with residual renal function and insulin resistance in end-stage renal disease patients receiving long-term peritoneal dialysis.
Fibroblast growth factor-21 (FGF-21) is a new metabolic regulator, which is related to antiobesity and insulin sensitivity in vivo. However, the clinical implication of FGF-21 is poorly understood. To investigate whether FGF-21 may play a role as a metabolic regulator in patients with end-stage renal disease, we measured serum concentrations of FGF-21, inflammatory markers, and metabolic parameters in healthy people (n = 63) and nondiabetic patients receiving peritoneal dialysis (PD, n = 72). The patients were treated with angiotensin receptor blocker for 6 months, and the changes in FGF-21 concentration and metabolic parameters were assessed. Compared with controls, serum FGF-21 concentration was 8 times higher in patients undergoing PD (754.2 ± 463.5 vs 86.9 ± 60.2 pg/mL, P < .001). In controls, only lipid parameters correlated positively with FGF-21 concentration. In contrast, inflammatory markers (interleukin-6, fibrinogen, high-sensitivity C-reactive protein) and homeostasis model assessment of insulin resistance (HOMA-IR) correlated positively and residual renal function correlated inversely with serum FGF-21 concentration in PD patients. In a multivariate analysis adjusting these factors, residual renal function, HOMA-IR, and fibrinogen concentration were independent determinants of serum FGF-21 concentration. After 6-month angiotensin receptor blocker treatment, serum FGF-21 concentration declined significantly by 13% and HOMA-IR and inflammatory markers improved in PD patients. These findings suggest that FGF-21 may play a role in insulin resistance in patients with end-stage renal disease.
Han
Seung Hyeok
SH
Division of Nephrology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
Choi
Sung Hee
SH
Cho
Bong Jun
BJ
Lee
Yenna
Y
Lim
Soo
S
Park
Young Joo
YJ
Moon
Min Kyung
MK
Lee
Hong Kyu
HK
Kang
Shin-Wook
SW
Han
Dae Suk
DS
Kim
Young-Bum
YB
Jang
Hak C
HC
Park
Kyong Soo
KS
D000328:Adult; D057911:Angiotensin Receptor Antagonists / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D015415:Biomarkers; D016022:Case-Control Studies; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D005346:Fibroblast Growth Factors / Q000097:blood* / Q000187:drug effects / Q000378:metabolism; D006801:Humans; D007249:Inflammation; D007333:Insulin Resistance; D007668:Kidney / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis
D057911:Angiotensin Receptor Antagonists; D015415:Biomarkers; C414620:fibroblast growth factor 21; D005346:Fibroblast Growth Factors; D005340:Fibrinogen