title: Increased circulating and epicardial adipose tissue mRNA expression of fibroblast growth factor-21 after cardiac surgery: possible role in postoperative inflammatory response and insulin resistance.
abstract: We studied the changes in serum fibroblast growth factor-21 (FGF-21) concentrations, its mRNA, and protein expression in skeletal muscle and adipose tissue of 15 patients undergoing cardiac surgery. Blood samples were obtained: prior to initiation of anesthesia, prior to the start of extracorporeal circulation, upon completion of the surgery, and 6, 24, 48, and 96 hours after the end of the surgery. Tissue sampling was performed at the start and end of surgery. The mean baseline serum FGF-21 concentration was 63.1 (43.03-113.95) pg/ml and it increased during surgery with peak 6 hours after its end [385.5 (274.55-761.65) pg/ml, p < 0.001], and returned to baseline value [41.4 (29.15-142.83) pg/ml] 96 hours after the end of the surgery. Serum glucose, insulin, CRP, IL-6, IL-8, MCP-1, and TNF-alpha concentrations significantly increased during the surgery. Baseline FGF-21 mRNA expression in skeletal muscle was higher than in both adipose tissue depots and it was not affected by the surgery. Epicardial fat FGF-21 mRNA increased after surgery. Muscle FGF-21 mRNA positively correlated with blood glucose levels at the end of the surgery. Our data suggest a possible role of FGF-21 in the regulation of glucose metabolism and insulin sensitivity in surgery-related stress.
authors.affiliation: Department of Anesthesia and Resuscitation, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
authors.forename: T
authors.initials: T
authors.lastname: Kotulák
authors.forename: J
authors.initials: J
authors.lastname: Drápalová
authors.forename: P
authors.initials: P
authors.lastname: Kopecký
authors.forename: Z
authors.initials: Z
authors.lastname: Lacinová
authors.forename: P
authors.initials: P
authors.lastname: Kramář
authors.forename: H
authors.initials: H
authors.lastname: Říha
authors.forename: I
authors.initials: I
authors.lastname: Netuka
authors.forename: J
authors.initials: J
authors.lastname: Malý
authors.forename: D
authors.initials: D
authors.lastname: Housa
authors.forename: J
authors.initials: J
authors.lastname: Bláha
authors.forename: Š
authors.initials: Š
authors.lastname: Svačina
authors.forename: M
authors.initials: M
authors.lastname: Haluzík
mesh_terms: D000273:Adipose Tissue / Q000378:metabolism*; D000368:Aged; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D005346:Fibroblast Growth Factors / Q000235:genetics / Q000378:metabolism*; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000378:metabolism*; D012333:RNA, Messenger / Q000378:metabolism; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology* / Q000378:metabolism*; D015854:Up-Regulation
chemical_list: D012333:RNA, Messenger; C414620:fibroblast growth factor 21; D005346:Fibroblast Growth Factors