循环 FGF21 水平升高可预测 2 型糖尿病成人的代谢需求负担和血管疾病风险。
Increased circulating FGF21 level predicts the burden of metabolic demands and risk of vascular diseases in adults with type 2 diabetes.
机构信息
School of Pharmaceutical College, Wenzhou Medical University, Wenzhou, China.
Department of Cardiology, The 1st affiliated Hospital of Wenzhou Medical Unversity, Wenzhou, China.
出版信息
BMC Endocr Disord. 2023 Dec 7;23(1):272. doi: 10.1186/s12902-023-01523-y.
OBJECTIVES
Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by chronic hyperglycemia and metabolic stress, involved in the stepwise development of cardiovascular complications. Fibroblast growth factor 21 (FGF21) is a novel hepatokine involved in regulating glucose and lipid metabolism, and has been linked to the prediction, treatment, and improvement of prognosis in multiple cardiovascular diseases (CVDs). The aim of this study is to explore the relationship between FGF21 levels and vascular diseases (VDs) including carotid atherosclerosis (CAS) and hypertension (HP) in patients with T2DM.
METHODS
Baseline serum FGF21 was determined in a cross-sectional study of 701 patients with T2DM and 258 healthy control.
RESULTS
The morbidity of CAS was increased in T2DM patients with HP as compared with those without (p < 0.001). The average serum FGF21 level of healthy was [123.9 (67.2-219.3)]. Baseline FGF21 was significantly higher in those who developed CAS or HP than in those who did not [305.9 (177.2-508.4) vs. 197.2 (129.7-308.3) pg/mL, p < 0.001]. In addition, an elevated serum FGF21 was observed in T2DM patients with HP and CAS than that of T2DM patients with CAS or HP [550.5 (312.6-711.3) vs. 305.9 pg/mL, p < 0.001]. Serum FGF21 levels were positively correlated with body mass index and carotid intima media thicknes (p < 0.05), the association remained significant after adjusting for age and T2DM duration. Furthermore, the multinomial logistic regression showed that serum FGF21 was independently associated with CAS and HP in patients with T2DM after adjustment for demographic and traditional VDs risk factors (p < 0.001).
CONCLUSIONS
Baseline FGF21 is elevated in VDs during diabetes, changes of serum FGF21 levels were appropriately matched to metabolic stress. FGF21can be used as an independent predictor for diagnosing VDs and predicting prognosis.
目的
2 型糖尿病（T2DM）是一种以慢性高血糖和代谢应激为特征的慢性代谢性疾病，涉及心血管并发症的逐步发展。成纤维细胞生长因子 21（FGF21）是一种新型的肝源细胞因子，参与调节糖和脂代谢，与多种心血管疾病（CVDs）的预测、治疗和预后改善有关。本研究旨在探讨 FGF21 水平与 T2DM 患者血管疾病（VDs）包括颈动脉粥样硬化（CAS）和高血压（HP）之间的关系。
方法
在一项横断面研究中，对 701 例 T2DM 患者和 258 例健康对照者进行了基线血清 FGF21 测定。
结果
与无 HP 的 T2DM 患者相比，伴有 HP 的 T2DM 患者的 CAS 发病率增加（p<0.001）。健康者的平均血清 FGF21 水平为[123.9（67.2-219.3）]pg/ml。与未发生 CAS 或 HP 的患者相比，发生 CAS 或 HP 的患者的基础 FGF21 水平显著升高[305.9（177.2-508.4）比 197.2（129.7-308.3）pg/ml，p<0.001]。此外，与 T2DM 患者单纯 CAS 或 HP 相比，T2DM 患者同时伴有 HP 和 CAS 时的血清 FGF21 水平更高[550.5（312.6-711.3）比 305.9 pg/ml，p<0.001]。血清 FGF21 水平与体重指数和颈动脉内膜中层厚度呈正相关（p<0.05），调整年龄和 T2DM 病程后相关性仍然显著。此外，多项逻辑回归显示，调整人口统计学和传统 VD 危险因素后，血清 FGF21 与 T2DM 患者的 CAS 和 HP 独立相关（p<0.001）。
结论
在糖尿病期间，VDs 时的基础 FGF21 升高，血清 FGF21 水平的变化与代谢应激相适应。FGF21 可作为诊断 VD 和预测预后的独立预测因子。
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