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- Publisher Website: 10.1210/jc.2014-3465
- Scopus: eid_2-s2.0-84927596453
- PMID: 25625802
- WOS: WOS:000353361500043
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Article: Circulating Fibroblast Growth Factor 21 Levels Predict Progressive Kidney Disease in Subjects With Type 2 Diabetes and Normoalbuminuria
Title | Circulating Fibroblast Growth Factor 21 Levels Predict Progressive Kidney Disease in Subjects With Type 2 Diabetes and Normoalbuminuria |
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Authors | |
Issue Date | 2015 |
Publisher | The 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? |
Abstract | BACKGROUND: 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 Identifier | http://hdl.handle.net/10722/211799 |
ISSN | 2023 Impact Factor: 5.0 2023 SCImago Journal Rankings: 1.899 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Lee, CHP | - |
dc.contributor.author | Hui, YLE | - |
dc.contributor.author | Woo, YC | - |
dc.contributor.author | Yeung, CY | - |
dc.contributor.author | Chow, WS | - |
dc.contributor.author | Yuen, MMA | - |
dc.contributor.author | Fong, HY | - |
dc.contributor.author | Xu, A | - |
dc.contributor.author | Lam, KSL | - |
dc.date.accessioned | 2015-07-21T02:11:05Z | - |
dc.date.available | 2015-07-21T02:11:05Z | - |
dc.date.issued | 2015 | - |
dc.identifier.citation | Journal of Clinical Endocrinology and Metabolism, 2015, v. 100 n. 4, p. 1368-1375 | - |
dc.identifier.issn | 0021-972X | - |
dc.identifier.uri | http://hdl.handle.net/10722/211799 | - |
dc.description.abstract | BACKGROUND: 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.language | eng | - |
dc.publisher | The Endocrine Society. The Journal's web site is located at http://jcem.endojournals.org | - |
dc.relation.ispartof | Journal of Clinical Endocrinology and Metabolism | - |
dc.title | Circulating Fibroblast Growth Factor 21 Levels Predict Progressive Kidney Disease in Subjects With Type 2 Diabetes and Normoalbuminuria | - |
dc.type | Article | - |
dc.identifier.email | Woo, YC: wooyucho@hku.hk | - |
dc.identifier.email | Yeung, CY: ycy167@hku.hk | - |
dc.identifier.email | Chow, WS: chowws01@hkucc.hku.hk | - |
dc.identifier.email | Fong, HY: kalofong@hku.hk | - |
dc.identifier.email | Xu, A: amxu@hkucc.hku.hk | - |
dc.identifier.email | Lam, KSL: ksllam@hku.hk | - |
dc.identifier.authority | Hui, YLE=rp01660 | - |
dc.identifier.authority | Xu, A=rp00485 | - |
dc.identifier.authority | Lam, KSL=rp00343 | - |
dc.description.nature | link_to_OA_fulltext | - |
dc.identifier.doi | 10.1210/jc.2014-3465 | - |
dc.identifier.pmid | 25625802 | - |
dc.identifier.scopus | eid_2-s2.0-84927596453 | - |
dc.identifier.hkuros | 244400 | - |
dc.identifier.volume | 100 | - |
dc.identifier.issue | 4 | - |
dc.identifier.spage | 1368 | - |
dc.identifier.epage | 1375 | - |
dc.identifier.isi | WOS:000353361500043 | - |
dc.publisher.place | United States | - |
dc.identifier.issnl | 0021-972X | - |