High circulating follistatin-like protein 1 as a biomarker of a metabolically unhealthy state

Sun Young Lee, Deog Yoon Kim, Mi Kyung Kwak, Seong Hee Ahn, Hyeonmok Kim, Beom Jun Kim, Jung Min Koh, Yumie Rhee, Chong Hwa Kim, Ki Hyun Baek, Yong Ki Min, Seung Hun Lee, Moo Il Kang

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The inflammatory biomarkers that fully characterize the metabolically unhealthy (MU) state-which is a risk factor for cardiovascular disease (CVD)-remain unclear. Recent studies suggest follistatin-like protein 1 (FSTL1) could be used as a biomarker for inflammation and CVD, however there is little information on FSTL1 levels in the MU state. We aimed to evaluate the associations between FSTL1, the presence of MU state and subclinical coronary atherosclerosis. In a cross-sectional study, we evaluated FSTL1 levels and their relationship with the presence of MU state and coronary artery plaques in 230 Korean patients. Significant increase in FSTL1 levels was observed in subjects with MU state (p = 0.020), but not those with obesity state according to body mass index criteria (p = 0.790). After adjusting for confounders, the odd ratio (OR) for the MU state among patients in the highest FSTL1 tertile (T3) was higher in comparison with the lowest tertile (T1) (OR = 3.60, 95% confidence interval [95% CI] = 1.20-10.83). In a subgroup (n = 66), FSTL1 levels were also marginally higher in patients with plaques (p = 0.098). The OR for plaque presence in patients with T3 was significantly higher in comparison with T1 after adjusting for confounders (OR = 12.51, 95% CI = 1.15-135.73). Plasma FSTL1 may be a useful biomarker for the risk of MU state and CVD.

Original languageEnglish
Pages (from-to)241-251
Number of pages11
JournalEndocrine Journal
Issue number3
Publication statusPublished - 2019 Jan 1


All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Lee, S. Y., Kim, D. Y., Kwak, M. K., Ahn, S. H., Kim, H., Kim, B. J., Koh, J. M., Rhee, Y., Kim, C. H., Baek, K. H., Min, Y. K., Lee, S. H., & Kang, M. I. (2019). High circulating follistatin-like protein 1 as a biomarker of a metabolically unhealthy state. Endocrine Journal, 66(3), 241-251. https://doi.org/10.1507/endocrj.EJ18-0352