Format

Send to

Choose Destination
Diabetologia. 2015 Mar;58(3):464-73. doi: 10.1007/s00125-014-3458-7. Epub 2014 Nov 26.

The relationship of fibroblast growth factor 21 with cardiovascular outcome events in the Fenofibrate Intervention and Event Lowering in Diabetes study.

Author information

1
Lipid Research Group, Heart Research Institute, Sydney, NSW, Australia, oklws@yahoo.com.hk.

Abstract

AIMS/HYPOTHESIS:

Circulating fibroblast growth factor 21 (FGF21) levels are often elevated in obesity, dyslipidaemia, insulin resistance and type 2 diabetes. This study investigated the relationship of plasma FGF21 levels with cardiovascular events in patients with type 2 diabetes.

METHODS:

Plasma FGF21 levels were measured by ELISA at baseline in 9,697 individuals with type 2 diabetes participating in the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study. We assessed the association of FGF21 levels with the incidence of different cardiovascular outcomes over 5 years. The primary outcome was total cardiovascular disease (CVD) events and the secondary outcomes were the four individual components: coronary heart disease events, total stroke, CVD mortality and coronary and carotid revascularisation. The tertiary outcome was hospitalisation for angina pectoris.

RESULTS:

Higher baseline FGF21 levels were associated with higher risks of all cardiovascular outcome events after adjusting for the study treatment allocation (all pā€‰<ā€‰0.01). The associations remained significant for total CVD events and for coronary and carotid revascularisation after further adjusting for confounding factors, with the HR (95% CI) being 1.28 (1.10, 1.50) and 1.26 (1.01, 1.56), respectively, for the highest tertile compared with the lowest tertile (overall effect pā€‰=ā€‰0.002 and 0.007, respectively). The addition of FGF21 levels to a model including established CVD risk factors predicting total CVD events led to a non-significant increase in the C-statistic but there was a significant improvement in integrated discrimination and net reclassification.

CONCLUSIONS/INTERPRETATION:

Higher baseline plasma FGF21 levels were associated with higher risk of cardiovascular events in patients with type 2 diabetes.

TRIAL REGISTRATION:

ISRCTN64783481.

PMID:
25425220
DOI:
10.1007/s00125-014-3458-7
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center