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Yan F, Yuan L, Yang F, Wu G, Jiang X. Emerging roles of fibroblast growth factor 21 in critical disease. Front Cardiovasc Med 2022; 9:1053997. [PMID: 36440004 PMCID: PMC9684205 DOI: 10.3389/fcvm.2022.1053997] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 10/19/2022] [Indexed: 03/01/2024] Open
Abstract
In spite of the great progress in the management of critical diseases in recent years, its associated prevalence and mortality of multiple organ failure still remain high. As an endocrine hormone, fibroblast growth factor 21 (FGF21) functions to maintain homeostasis in the whole body. Recent studies have proved that FGF21 has promising potential effects in critical diseases. FGF21 has also been found to have a close relationship with the progression of critical diseases and has a great predictive function for organ failure. The level of FGF21 was elevated in both mouse models and human patients with sepsis or other critical illnesses. Moreover, it is a promising biomarker and has certain therapeutic roles in some critical diseases. We focus on the emerging roles of FGF21 and its potential effects in critical diseases including acute lung injury/acute respiratory distress syndrome (ALI/ARDS), acute myocardial injury (AMI), acute kidney injury (AKI), sepsis, and liver failure in this review. FGF21 has high application value and is worth further studying. Focusing on FGF21 may provide a new perspective for the management of the critical diseases.
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Affiliation(s)
- Fang Yan
- Department of Geriatrics, Chengdu Fifth People’s Hospital, Geriatric Diseases Institute of Chengdu, Chengdu, China
- Center for Medicine Research and Translation, Chengdu Fifth People’s Hospital, Chengdu, China
| | - Li Yuan
- Department of Clinical Laboratory Medicine, Chengdu Fifth People’s Hospital, Chengdu, China
| | - Fan Yang
- Department of Endocrinology, Chengdu Fifth People’s Hospital, Chengdu, China
| | - Guicheng Wu
- Department of Hepatology, School of Medicine, Chongqing Municipality Clinical Research Center for Endocrinology and Metabolic Diseases, Chongqing University Three Goreges Hosipital, Chongqing University, Chongqing, China
| | - Xiaobo Jiang
- Department of Cardiology, Chengdu Fifth People’s Hospital, Chengdu, China
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Wu G, Wu S, Yan J, Gao S, Zhu J, Yue M, Li Z, Tan X. Fibroblast Growth Factor 21 Predicts Short-Term Prognosis in Patients With Acute Heart Failure: A Prospective Cohort Study. Front Cardiovasc Med 2022; 9:834967. [PMID: 35369322 PMCID: PMC8965840 DOI: 10.3389/fcvm.2022.834967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 01/31/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Recent studies of fibroblast growth factor 21 (FGF21), first recognized as a regulator of glucose and lipid metabolism, have found that the level of in serum FGF21 is associated with the prognosis of many cardiovascular diseases, but its relationship to acute heart failure (AHF) patients remains unknown. Our study aimed to investigate whether circulating FGF21 could predict the short-term prognosis of AHF patients. METHODS Four hundred and two AHF patients and 19 healthy controls were recruited into the prospective cohort study, and blood samples of participants were collected, in tubes without anticoagulant, within the first 24 h after hospital admission. Serum FGF21 levels were detected by enzyme-linked immunosorbent assay (ELISA). All patients were followed-up at least 6 months after discharge. The primary endpoint was all-cause death, and secondary endpoint was a composite endpoint of death and heart failure readmission. Mortality and composite end point events were analyzed using Kaplan-Meier curves. ROC curves compared the difference between the FGF21 and NT-proBNP in predicting 3- and 6-months mortality. Time-to-event data were evaluated using Kaplan-Meier estimation and Cox proportional hazards models. RESULTS In the present study, the serum FGF21 concentrations were significantly higher in the 402 AHF patients enrolled, compared with the 19 healthy controls (p < 0.001). The average age was 70 (±12) years, and 58% were males. Participants were divided into two groups according to the median FGF21 level (262 pg/ml): a high FGF21 group (n = 201, FGF21 ≥ 262 pg/ml) and low FGF21 group (n = 201, FGF21 <262 pg/ml). FGF21 was positively correlated with NT-proBNP, BUN, AST, creatinine and cholesterol, and negatively correlated with ALB and HDL. After a median follow-up of 193 days, the high FGF21 group had higher mortality and composite endpoint events compared with the low FGF21 group (HR: 3.91, 95% CI 2.21-6.92, p <0.001), even after adjusting for NT-proBNP (HR: 3.17, 95% CI 1.72-5.81, p < 0.001). ROC analysis shows that FGF21 was better than NT-proBNP in predicting death at both 3 (AUC, 0.77 vs. 0.63, p < 0.001) and 6 months (AUC, 0.78 vs. 0.66). CONCLUSION High baseline FGF21 levels are associated with adverse clinical outcomes in AHF patients. Serum FGF21 might be a potential predictive biomarker of AHF patients.
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Affiliation(s)
- Guihai Wu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Shenglin Wu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Jingyi Yan
- Department of Cardiovascular Medicine, First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Shanshan Gao
- Department of Cardiovascular Medicine, First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Jinxiu Zhu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Minghui Yue
- Department of Cardiovascular Medicine, First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Zexin Li
- Department of Cardiovascular Medicine, First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Xuerui Tan
- Department of Cardiovascular Medicine, First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Clinical Research Center, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
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