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Article: Circulating Fibroblast Growth Factor 21 Levels Predict Progressive Kidney Disease in Subjects With Type 2 Diabetes and Normoalbuminuria

TitleCirculating Fibroblast Growth Factor 21 Levels Predict Progressive Kidney Disease in Subjects With Type 2 Diabetes and Normoalbuminuria
Authors
Issue Date2015
PublisherThe Endocrine Society. The Journal's web site is located at http://jcem.endojournals.org
Citation
Journal of Clinical Endocrinology and Metabolism, 2015, v. 100 n. 4, p. 1368-1375 How to Cite?
AbstractBACKGROUND: Elevated fibroblast growth factor 21 (FGF21) levels have been suggested, from cross-sectional studies, as an indicator of subclinical diabetic nephropathy. We investigated whether serum FGF21 was predictive of the development of diabetic nephropathy. METHOD: Baseline serum FGF21 levels were measured in 1136 Chinese type 2 diabetic subjects recruited from the Hong Kong West Diabetes Registry. The role of serum FGF21 in predicting decline in estimated glomerular filtration rate (eGFR) over a median follow-up of 4 years was analyzed using Cox regression analysis. RESULTS: At baseline, serum FGF21 levels increased progressively with eGFR category (P for trend <.001). Among 1071 subjects with baseline eGFR ≥ 30 mL/min/1.73 m(2), serum FGF21 levels were significantly higher in those with eGFR decline during follow-up (n = 171) than those without decline (n = 900) (P < .001). In multivariable Cox regression analysis, baseline serum FGF21 was independently associated with eGFR decline (hazard ratio, 1.21; 95% confidence interval [CI], 1.01-1.43; P = .036), even after adjustment for baseline eGFR. In a subgroup of 559 subjects with baseline eGFR ≥ 60 mL/min/1.73 m(2) and normoalbuminuria, serum FGF21 level remained an independent predictor of eGFR decline (hazard ratio, 1.36; 95% CI, 1.06-1.76; P = .016). Integrated discrimination improvement (IDI) suggested that the inclusion of baseline serum FGF21 significantly improved the prediction of eGFR decline (IDI, 1%; 95% CI, 0.1-3.0; P = .013) in this subgroup, but not in the initial cohort involving all subjects. CONCLUSIONS: Elevated serum FGF21 levels may be a useful biomarker for predicting kidney disease progression, especially in the early stages of diabetic nephropathy.
Persistent Identifierhttp://hdl.handle.net/10722/211799
ISSN
2015 Impact Factor: 5.531
2015 SCImago Journal Rankings: 2.940

 

DC FieldValueLanguage
dc.contributor.authorLee, CHP-
dc.contributor.authorHui, YLE-
dc.contributor.authorWoo, YC-
dc.contributor.authorYeung, CY-
dc.contributor.authorChow, WS-
dc.contributor.authorYuen, MMA-
dc.contributor.authorFong, HY-
dc.contributor.authorXu, A-
dc.contributor.authorLam, KSL-
dc.date.accessioned2015-07-21T02:11:05Z-
dc.date.available2015-07-21T02:11:05Z-
dc.date.issued2015-
dc.identifier.citationJournal of Clinical Endocrinology and Metabolism, 2015, v. 100 n. 4, p. 1368-1375-
dc.identifier.issn0021-972X-
dc.identifier.urihttp://hdl.handle.net/10722/211799-
dc.description.abstractBACKGROUND: Elevated fibroblast growth factor 21 (FGF21) levels have been suggested, from cross-sectional studies, as an indicator of subclinical diabetic nephropathy. We investigated whether serum FGF21 was predictive of the development of diabetic nephropathy. METHOD: Baseline serum FGF21 levels were measured in 1136 Chinese type 2 diabetic subjects recruited from the Hong Kong West Diabetes Registry. The role of serum FGF21 in predicting decline in estimated glomerular filtration rate (eGFR) over a median follow-up of 4 years was analyzed using Cox regression analysis. RESULTS: At baseline, serum FGF21 levels increased progressively with eGFR category (P for trend <.001). Among 1071 subjects with baseline eGFR ≥ 30 mL/min/1.73 m(2), serum FGF21 levels were significantly higher in those with eGFR decline during follow-up (n = 171) than those without decline (n = 900) (P < .001). In multivariable Cox regression analysis, baseline serum FGF21 was independently associated with eGFR decline (hazard ratio, 1.21; 95% confidence interval [CI], 1.01-1.43; P = .036), even after adjustment for baseline eGFR. In a subgroup of 559 subjects with baseline eGFR ≥ 60 mL/min/1.73 m(2) and normoalbuminuria, serum FGF21 level remained an independent predictor of eGFR decline (hazard ratio, 1.36; 95% CI, 1.06-1.76; P = .016). Integrated discrimination improvement (IDI) suggested that the inclusion of baseline serum FGF21 significantly improved the prediction of eGFR decline (IDI, 1%; 95% CI, 0.1-3.0; P = .013) in this subgroup, but not in the initial cohort involving all subjects. CONCLUSIONS: Elevated serum FGF21 levels may be a useful biomarker for predicting kidney disease progression, especially in the early stages of diabetic nephropathy.-
dc.languageeng-
dc.publisherThe Endocrine Society. The Journal's web site is located at http://jcem.endojournals.org-
dc.relation.ispartofJournal of Clinical Endocrinology and Metabolism-
dc.titleCirculating Fibroblast Growth Factor 21 Levels Predict Progressive Kidney Disease in Subjects With Type 2 Diabetes and Normoalbuminuria-
dc.typeArticle-
dc.identifier.emailWoo, YC: wooyucho@hku.hk-
dc.identifier.emailYeung, CY: ycy167@hku.hk-
dc.identifier.emailChow, WS: chowws01@hkucc.hku.hk-
dc.identifier.emailFong, HY: kalofong@hku.hk-
dc.identifier.emailXu, A: amxu@hkucc.hku.hk-
dc.identifier.emailLam, KSL: ksllam@hku.hk-
dc.identifier.authorityHui, YLE=rp01660-
dc.identifier.authorityXu, A=rp00485-
dc.identifier.authorityLam, KSL=rp00343-
dc.identifier.doi10.1210/jc.2014-3465-
dc.identifier.pmid25625802-
dc.identifier.hkuros244400-
dc.identifier.volume100-
dc.identifier.issue4-
dc.identifier.spage1368-
dc.identifier.epage1375-
dc.publisher.placeUnited States-

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