Serum fibroblast growth factor-21 concentration is associated with residual renal function and insulin resistance in end-stage renal disease patients receiving long-term peritoneal dialysis

Seung Hyeok Han, Sung Hee Choi, Bong Jun Cho, Yenna Lee, Soo Lim, Young Joo Park, Min Kyung Moon, Hong Kyu Lee, Shin Wook Kang, Dae Suk Han, Young Bum Kim, Hak C. Jang, Kyong Soo Park

Research output: Contribution to journalArticle

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Abstract

Fibroblast growth factor-21 (FGF-21) is a new metabolic regulator, which is related to antiobesity and insulin sensitivity in vivo. However, the clinical implication of FGF-21 is poorly understood. To investigate whether FGF-21 may play a role as a metabolic regulator in patients with end-stage renal disease, we measured serum concentrations of FGF-21, inflammatory markers, and metabolic parameters in healthy people (n = 63) and nondiabetic patients receiving peritoneal dialysis (PD, n = 72). The patients were treated with angiotensin receptor blocker for 6 months, and the changes in FGF-21 concentration and metabolic parameters were assessed. Compared with controls, serum FGF-21 concentration was 8 times higher in patients undergoing PD (754.2 ± 463.5 vs 86.9 ± 60.2 pg/mL, P < .001). In controls, only lipid parameters correlated positively with FGF-21 concentration. In contrast, inflammatory markers (interleukin-6, fibrinogen, high-sensitivity C-reactive protein) and homeostasis model assessment of insulin resistance (HOMA-IR) correlated positively and residual renal function correlated inversely with serum FGF-21 concentration in PD patients. In a multivariate analysis adjusting these factors, residual renal function, HOMA-IR, and fibrinogen concentration were independent determinants of serum FGF-21 concentration. After 6-month angiotensin receptor blocker treatment, serum FGF-21 concentration declined significantly by 13% and HOMA-IR and inflammatory markers improved in PD patients. These findings suggest that FGF-21 may play a role in insulin resistance in patients with end-stage renal disease.

Original languageEnglish
Pages (from-to)1656-1662
Number of pages7
JournalMetabolism: Clinical and Experimental
Volume59
Issue number11
DOIs
Publication statusPublished - 2010 Nov 1

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Peritoneal Dialysis
Chronic Kidney Failure
Insulin Resistance
Kidney
Serum
Homeostasis
Angiotensin Receptor Antagonists
Fibrinogen
fibroblast growth factor 21
C-Reactive Protein
Interleukin-6
Multivariate Analysis
Lipids

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Han, Seung Hyeok ; Choi, Sung Hee ; Cho, Bong Jun ; Lee, Yenna ; Lim, Soo ; Park, Young Joo ; Moon, Min Kyung ; Lee, Hong Kyu ; Kang, Shin Wook ; Han, Dae Suk ; Kim, Young Bum ; Jang, Hak C. ; Park, Kyong Soo. / Serum fibroblast growth factor-21 concentration is associated with residual renal function and insulin resistance in end-stage renal disease patients receiving long-term peritoneal dialysis. In: Metabolism: Clinical and Experimental. 2010 ; Vol. 59, No. 11. pp. 1656-1662.
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Serum fibroblast growth factor-21 concentration is associated with residual renal function and insulin resistance in end-stage renal disease patients receiving long-term peritoneal dialysis. / Han, Seung Hyeok; Choi, Sung Hee; Cho, Bong Jun; Lee, Yenna; Lim, Soo; Park, Young Joo; Moon, Min Kyung; Lee, Hong Kyu; Kang, Shin Wook; Han, Dae Suk; Kim, Young Bum; Jang, Hak C.; Park, Kyong Soo.

In: Metabolism: Clinical and Experimental, Vol. 59, No. 11, 01.11.2010, p. 1656-1662.

Research output: Contribution to journalArticle

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T1 - Serum fibroblast growth factor-21 concentration is associated with residual renal function and insulin resistance in end-stage renal disease patients receiving long-term peritoneal dialysis

AU - Han, Seung Hyeok

AU - Choi, Sung Hee

AU - Cho, Bong Jun

AU - Lee, Yenna

AU - Lim, Soo

AU - Park, Young Joo

AU - Moon, Min Kyung

AU - Lee, Hong Kyu

AU - Kang, Shin Wook

AU - Han, Dae Suk

AU - Kim, Young Bum

AU - Jang, Hak C.

AU - Park, Kyong Soo

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N2 - Fibroblast growth factor-21 (FGF-21) is a new metabolic regulator, which is related to antiobesity and insulin sensitivity in vivo. However, the clinical implication of FGF-21 is poorly understood. To investigate whether FGF-21 may play a role as a metabolic regulator in patients with end-stage renal disease, we measured serum concentrations of FGF-21, inflammatory markers, and metabolic parameters in healthy people (n = 63) and nondiabetic patients receiving peritoneal dialysis (PD, n = 72). The patients were treated with angiotensin receptor blocker for 6 months, and the changes in FGF-21 concentration and metabolic parameters were assessed. Compared with controls, serum FGF-21 concentration was 8 times higher in patients undergoing PD (754.2 ± 463.5 vs 86.9 ± 60.2 pg/mL, P < .001). In controls, only lipid parameters correlated positively with FGF-21 concentration. In contrast, inflammatory markers (interleukin-6, fibrinogen, high-sensitivity C-reactive protein) and homeostasis model assessment of insulin resistance (HOMA-IR) correlated positively and residual renal function correlated inversely with serum FGF-21 concentration in PD patients. In a multivariate analysis adjusting these factors, residual renal function, HOMA-IR, and fibrinogen concentration were independent determinants of serum FGF-21 concentration. After 6-month angiotensin receptor blocker treatment, serum FGF-21 concentration declined significantly by 13% and HOMA-IR and inflammatory markers improved in PD patients. These findings suggest that FGF-21 may play a role in insulin resistance in patients with end-stage renal disease.

AB - Fibroblast growth factor-21 (FGF-21) is a new metabolic regulator, which is related to antiobesity and insulin sensitivity in vivo. However, the clinical implication of FGF-21 is poorly understood. To investigate whether FGF-21 may play a role as a metabolic regulator in patients with end-stage renal disease, we measured serum concentrations of FGF-21, inflammatory markers, and metabolic parameters in healthy people (n = 63) and nondiabetic patients receiving peritoneal dialysis (PD, n = 72). The patients were treated with angiotensin receptor blocker for 6 months, and the changes in FGF-21 concentration and metabolic parameters were assessed. Compared with controls, serum FGF-21 concentration was 8 times higher in patients undergoing PD (754.2 ± 463.5 vs 86.9 ± 60.2 pg/mL, P < .001). In controls, only lipid parameters correlated positively with FGF-21 concentration. In contrast, inflammatory markers (interleukin-6, fibrinogen, high-sensitivity C-reactive protein) and homeostasis model assessment of insulin resistance (HOMA-IR) correlated positively and residual renal function correlated inversely with serum FGF-21 concentration in PD patients. In a multivariate analysis adjusting these factors, residual renal function, HOMA-IR, and fibrinogen concentration were independent determinants of serum FGF-21 concentration. After 6-month angiotensin receptor blocker treatment, serum FGF-21 concentration declined significantly by 13% and HOMA-IR and inflammatory markers improved in PD patients. These findings suggest that FGF-21 may play a role in insulin resistance in patients with end-stage renal disease.

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