Serum levels of FGF-21 are increased in coronary heart disease patients and are independently associated with adverse lipid profile

Zhuofeng Lin, Zhen Wu, Xiaojing Yin, Yanlong Liu, Xinxin Yan, Shaoqiang Lin, Jian Xiao, Xiaojie Wang, Wenke Feng, Xiaokun Li, Zhuofeng Lin, Zhen Wu, Xiaojing Yin, Yanlong Liu, Xinxin Yan, Shaoqiang Lin, Jian Xiao, Xiaojie Wang, Wenke Feng, Xiaokun Li

Abstract

Background: Fibroblast growth factor 21 (FGF-21) is a metabolic regulator with multiple beneficial effects on glucose homeostasis and lipid metabolism in animal models. The relationship between plasma levels of FGF-21 and coronary heart disease (CHD) in unknown.

Methodology/principal findings: This study aimed to investigate the correlation of serum FGF-21 levels and lipid metabolism in the patients with coronary heart disease. We performed a logistic regression analysis of the relation between serum levels of FGF-21 and CHD patients with and without diabetes and hypertension. This study was conducted in the Departments of Endocrinology and Cardiovascular Diseases at two University Hospitals. Participants consisted of one hundred and thirty-five patients who have been diagnosed to have CHD and sixty-one control subjects. Serum FGF-21 level and levels of fasting blood glucose; triglyceride; apolipoprotein B100; HOMA-IR; insulin; total cholesterol; HDL-cholesterol; LDL-cholesterol; and C-reactive protein were measured. We found that median serum FGF-21 levels were significantly higher in CHD than that of control subjects (P<0.0001). Serum FGF-21 levels in CHD patients with diabetes, hypertension, or both were higher than that of patients without these comorbidities. Serum FGF-21 levels correlated positively with triglycerides, fasting blood glucose, apolipoprotein B100, insulin and HOMA-IR but negatively with HDL-C and apolipoprotein A1 after adjusting for BMI, diabetes and hypertension. Logistic regression analysis demonstrated that FGF-21 showed an independent association with triglyceride and apolipoprotein A1.

Conclusions/significance: High levels of FGF-21 are associated with adverse lipid profiles in CHD patients. The paradoxical increase of serum FGF-21 in CHD patients may indicate a compensatory response or resistance to FGF-21.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Serum FGF-21 concentrations in subjects…
Figure 1. Serum FGF-21 concentrations in subjects with CHD and normal controls.
A, Serum FGF-21 levels of 135 CHD patients and 61 control subjects. B, Serum FGF-21 levels of CHD patients with diabetes (CHD+DIA, n = 61) and CHD patients without diabetes (CHD, n = 74). C, Serum FGF-21 levels of CHD patients with hypertension (H, n = 97) and CHD patients without hypertension (NH, n = 38). D, Serum FGF-21 levels of CHD patients with diabetes and hypertension (H+D, n = 45) and CHD patients without diabetes and hypertension (NH+ND, n = 21).
Figure 2. Correlation of serum FGF-21 levels…
Figure 2. Correlation of serum FGF-21 levels with adverse lipid metabolism and insulin resistance.
Regression analysis of serum levels of FGF-21 (log transformed) with HDL-cholesterol (A), Fasting glucose (B), Triglyceride (C) and Apolipoprotein AI (D) in 196 subjects.

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