MP601RELATIONSHIP BETWEEN SERUM FIBROBLAST GROWTH FACTOR 21 LEVELS AND ARTERIOSCLEROSIS FACTORS IN CHRONIC HEMODIALYSIS PATIENTS

Abstract

INTRODUCTION AND AIMS: Fibroblast growth factor 21 (FGF21) is an important metabolic regulator with multiple beneficial effects on glucose and lipid homeostasis. Circulating FGF21 levels are elevated in obese subjects and patients with impaired glucose tolerance, type 2 diabetes mellitus, dyslipidemia. In addition, circulating FGF21 levels are positively associated with body adiposity index, insulin resistance and hepatic lipid levels. Recently, FGF21 has been demonstrated to be associated with cardiovascular diseases such as carotid atherosclerosis and coronary heart disease. Meanwhile, it has been reported that in patients with CKD, the prevalence of arteriosclerosis (remodelling of large arteries) and cardiomyopathy was higher than in general population. The aim of this study is to evaluate arteriosclerosis factors associated with FGF21 levels in hemodialysis patients. METHOD(S): 47 hemodialysis patients (age: 67.6 +/-10.5 years, Male:68 %, BMI: 21.7 +/-3.3 kg/m2 ), who had undergone multi detector computed tomography (MDCT), were enrolled in this study. We evaluated relationship between FGF21 and atherosclerosis or related factors, such as BMI, dry weight and blood pressure during during hemodialysis session, the presence of diabetes mellitus, hemoglobin (Hb) levels, albumin levels, beta2 microglobulin levels, total cholesterol (LDL-C) levels, high-density lipoprotein-cholesterol (HDL-C) levels, triglyceride (TG) levels, pulse wave velocity (PWV), anklebrachial index (ABI), aortic calcification and cerebrovascular calcification. Aortic calcification was evaluated by calcification volume from aortic arch to iliac artery bifurcation using MDCT. Cerebrovascular calcification was evaluated by total number as one point which was defined in case of calcification existence in each artery of the brain, which was right or left internal carotid artery, middle cerebral artery, posterior cerebral artery, right or left vertebral artery or basilar artery, using MDCT. RESULT(S): Mean FGF21 level was 778.7 +/-611.6 pg/ml. In the univariate analysis, FGF21 level was significantly correlated with albumin levels (r=-0.149, P=0.003), beta2microglobulin levels (r=0.458, P=0.001), PWV (r=0.293, P=0.048), diastolic pressure (r=-0.303, P=0.038). In the multivariate regression model, all variables with a P value less than 0.1 in the univariate analysis were included. Multivariate analysis showed that albumin levels (beta value=-0.270, P=0.049), beta2 microglobulin levels (beta value=0.344, P=0.008) and cerebrovascular calcification (beta value=-0.287, P=0.016) were significant independent determinants of FGF21 levels. CONCLUSION(S): In the current literature, clinical studies suggest that beta2 microglobulin level is an independent, significant predictor of mortality and seems to be a factor strongly linked to the presence and severity of cardiovascular diseases. In this study, as beta2 microglobulin level was a significant independent determinant of FGF21 level, FGF21 level in hemodialysis patients may associate not only with atherosclerosis related factors but also with cerebrovascular calcification.