Serum fibroblast growth factor 21 concentrations in type 2 diabetic retinopathy patients.
OBJECTIVE
Fibroblast growth factor 21 (FGF21) is a major metabolic regulator in the body that has been shown to be elevated in a number of metabolic disturbances including type 2 diabetes mellitus (T2DM) and the metabolic syndrome. However, little is known regarding the circulating levels of FGF21 in type 2 diabetic retinopathy (T2DR) and its association with the severity of the condition.


METHODS
In a cross-sectional setting, 142 individuals, consisting of (1) T2DM patients without T2DR, (2) T2DM patients with T2DR, and (3) healthy control subjects were recruited for this study. Various clinical and biochemical parameters were assessed and entered for analysis.


RESULTS
Serum FGF21 levels were significantly elevated in T2DM subjects without retinopathy (103.50 [75.75] pg/mL) compared with healthy controls (99.00 [126.75] pg/mL). Circulating FGF21 levels were comparable across different stages of T2DR (233.00 [109.00] for nonproliferative type 2 diabetic retinopathy [NPT2DR] vs. 215.00 [122.00] for proliferative type 2 diabetic retinopathy [PT2DR] groups, P=361). FGF21, triglycerides, and duration of diabetes mellitus were significantly associated with T2DM in baseline models. However, after adjustment for potential confounders, in the final multivariate model, FGF21 emerged as the only significant factor associated with T2DM (OR=13.772, 95% CI=3.062-61.948, P=001).


CONCLUSIONS
Serum FGF21 concentrations are markedly elevated in patients with T2RN. The association between FGF21 and T2DR appears to be independent of the effects of potential confounding variables. These findings may suggest FGF21 as a novel surrogate diagnostic biomarker in initial stages of T2DR (particularly with FGF21 values above 135.5pg/mL).
Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: esteghamati@tums.ac.ir.
Alireza
A
Esteghamati
Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: A1_momeni@yahoo.com.
Alireza
A
Momeni
Department of Ophthalmology, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: Ali@abdollahi.org.
Ali
A
Abdollahi
Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: Amirhossein_kh29@yahoo.com.
Amirhossein
A
Khandan
Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: Mhafarideh@gmail.com.
Mohsen
M
Afarideh
Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: Sina.noshad@gmail.com.
Sina
S
Noshad
Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: Nakhjavanim@tums.ac.ir.
Manouchehr
M
Nakhjavani
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications; D003930:Diabetic Retinopathy / Q000097:blood*; D005260:Female; D005346:Fibroblast Growth Factors / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index
D015415:Biomarkers; C414620:fibroblast growth factor 21; D005346:Fibroblast Growth Factors
Facteur de croissance des fibroblastes 21; Fibroblast growth factor 21; Nonproliferative retinopathy; Proliferative retinopathy; Rétinopathie diabétique de type 2; Rétinopathie non proliférante; Rétinopathie proliférante; Type 2 diabetic retinopathy