Relationship of fibroblast growth factor 21 with subclinical atherosclerosis and cardiovascular events: Multi-Ethnic Study of Atherosclerosis. (August 2019)

• Record Type: Journal Article
• Authors: Ong, Kwok Leung; Campbell, Steven; Wu, Ben J.; McClelland, Robyn L.; Kokkinos, John; Szklo, Moyses; Polak, Joseph F.; Allison, Matthew A.; Rye, Kerry-Anne
• Is Part Of: Atherosclerosis. Volume 287(2019)
• Page Start: 46
• Page End: 53
• Publication Date: 2019-08
• Subjects: Ankle-brachial index -- Cardiovascular disease -- Carotid intima-media thickness -- Coronary artery calcification -- Fibroblast growth factor 21; Arteriosclerosis -- Periodicals; Electronic journals; 616.136
• DOI: 10.1016/j.atherosclerosis.2019.06.898
• Languages: English
• ISSNs: 0021-9150

Abstract

Abstract: Background and aims: Fibroblast growth factor 21 (FGF21) has been suggested as a novel biomarker for cardiovascular disease (CVD), especially in people with high CVD risk. However, it is not known whether FGF21 is a CVD biomarker in an initially healthy cohort. We therefore investigated the relationship of plasma FGF21 levels with measures of subclinical atherosclerosis and cardiovascular events in Multi-Ethnic Study of Atherosclerosis participants without known CVD at baseline. Methods: A total of 5788 participants had plasma FGF21 levels measured at the baseline exam (2000–2002). Carotid intima-media thickness (IMT), ankle-brachial index (ABI) and coronary artery calcification (CAC) were measured at baseline. Participants were followed up for incident CVD events over a median period of 14 years. Results: In cross-sectional analyses adjusting for socio-demographic variables, participants with higher FGF21 levels had higher carotid IMT, lower ABI, and higher prevalence of CAC ( p < 0.001). However, these associations were not significant after simultaneously adjusting for demographic, socioeconomic and lifestyle factors, traditional CVD risk factors, and biomarkers of inflammation and hemostasis. Among 5768 patients with follow-up data, 820 developed incident CVD endpoints. Higher baseline FGF21 levels were not associated with the risk for incident CVD endpoints after adjusting for multiple confounding factors (odds ratio 1.03; 95% confidence interval, 0.94–1.12, per SD increase in ln-transformed FGF21 levels). Conclusions: Although FGF21 has been suggested as a CVD biomarker for people with high CVD risk, our findings do not support a role of FGF21 as a CVD biomarker in those without a history of CVD. Graphical abstract: Image 1 Highlights: It was not known whether FGF21 is a CVD biomarker in a general population. Baseline FGF21 levels were measured in MESA participants free of CVD at baseline. FGF21 levels were not cross-sectionally associated with carotid IMT, ABI and CAC. FGF21 levels were not associated with incident CVD after multiple adjustment. FGF21 may not be a useful CVD biomarker in people without a history of CVD.