ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 20 of 45
УЖМБС 2018, 3(4): 110–114
Clinical Medicine

Metabolic Values of Fibroblasts Growth Factor 21 in Patients with Coronary Artery Disease and Obesity

Pasiyeshvili L. M, Ivanova K. V.

Recent studies have revealed that fibroblast growth factor 21 (FGF21) plays important role in energy metabolism regulation. FGF21 contributes to many age-related metabolic disorders, e.g. atherosclerosis, obesity, type 2 diabetes, and some cardiovascular diseases. The article presents study of fibroblast growth factor (FGF 21) in patients with coronary artery disease (CAD) depending on bone mass index (BMI). FGF 21 member of a group of hormones of the FGF family, which controls metabolic multi-branch cross-processes, that increases energy expenditure by glucose and lipid metabolism. A number of researchers suggest using FGF21 as a biomarker for subclinical atherosclerosis. The effects of FRF21 include hypolipidemic, anti inflammatory and antioxidant. FRF21 inhibits the key processes in the pathogenesis of atherosclerosis, which neutralizes the effect of cardiovascular risk factors by affecting endothelial cells. The purpose of study was to determine the dynamics of FGF 21 in patients with CAD, depending on the degree of obesity level, and also to assess the presence and of FGF21 with lipid metabolism parameters. Material and methods. We examined 98 people with CAD who were divided into four groups depending on the degree of obesity. In first group were patients with CAD and normal weight (n = 19), the second – with CAD and overweight (n = 24), third – CAD and obesity I degree (n = 31), fourth – CAD with 2 degree obesity (n = 31). The average age of patients was 51.8 ± 1.94 years; 52.4 ± 1.44 years; 52.2 ± 1.54 years; 53.1 ± 1.23 years, respectively. Gender ratios corresponded to the following: in all groups, women predominated – 54.8%; 52.9%; 51.2%; 53.6% respectively. The determination of FGF 21 was performed using the ELISA Kit AVISCERA BIOSCIENCE SK00145-01, USA, using the ELISA method. The control group included 20 healthy people of the same sex and age. All participants underwent complex laboratory and instrumental cardiovascular assessment. The statistical analysis was conducted using Mann- Whitney Spearman`s rank correlation. Results. Conducting a study of the lipid spectrum of blood allowed determining that the course of CAD occurs against the background of increased lipid metabolism. The level of FGF21 was 2-fold higher in patients with CAD and concomitant obesity l compared to the control group. The FGF21 level in the group with CAD without obesity was lower that with obesity 1, but higher that in the control group. Total cholesterol, low density lipoprotein cholesterol and triglycerides in patients with CAD and concomitant obesity there were increased compared to the control group. FGF21 correlated with total cholesterol, low density lipoprotein cholesterol, triglycerides. High stage of obesity in patients with CAD can play important role for development of insulin resistance or type 2 diabetes mellitus. This assumption is the result of studies with show the protective role of this hormone in the development of changes in carbohydrate metabolism. Conclusions. Our findings suggest that FGF21 is associated with the level of dyslipidemia. It may be speculated that FGF21 related to the risk factor of coronary artery disease and may be considered an as independent marker of lipid metabolism impairment. Level of FGF21 in patients with CAD and obesity was like in control, which, in our opinion, was the result of the development of fatty liver dystrophy and, as a consequence, a decrease in the "hepatic" synthesis of the studied hormone.

Keywords: FGF 21, coronary artery disease, obesity

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  1. Nakaz MOZ №152 vіd 02.03.16. Pro zatverdzhennya ta vprovadzhennya mediko-tekhnologіchnih dokumentіv zі standartizacії medichnoy dopomogi pri stabіl'nіj іshemіchnіj hvorobі sercya. [Ukrainian]
  2. Roth GA, Forouzanfar MH, Moran AE, Barber R, Nguyen G, Feigin VL, Naghavi M, Mensah GA, Murray CJL. Demographic and epidemiologic drivers of global cardiovascular mortality. Engl J Med. 2015; 372: 1333-41.
  3. VOZ centr SMI. Ozhirenie i izbytochnyj ves Informacionnyj byulleten' N°311 2015 Jan. [digital resource]. Available from [Russian]
  4. Woo YC, Xu A, Wang Y, Lam KS. Fibroblast Growth Factor 21 as an emerging metabolic regulator: clinical perspectives. Clin Endocrinol. (Oxf), 2013 Apr; 78 (4): 489-96.
  5. Salminen A, Kaarniranta K, Kauppinen A. Regulation of longevity by FGF21: Interaction between energy metabolism and stress responses. Ageing Res Rev. 2017; 37: 79-93.
  6. Giralt M, Gavaldà-Navarro A, Villarroya F. Fibroblast growth factor-21, energy balance and obesity. Mol Cell Endocrinol. 2015 Dec 15; 418 Pt 1: 66-73.
  7. Jin L, Lin Z, Xu A. Fibroblast growth factor 21 protects against atherosclerosis via fine-tuning the multiorgan crosstalk. Diabetes Metab J. 2016; 40 (1): 22-31.
  8. Wang XM, Song SS, Xiao H, Gao P, Li XJ, Si LY. Fibroblast growth factor 21 protects against high glucose induced cellular damage and dysfunction of endothelial nitricoxide synthase in endothelial cells. Cell Physiol Biochem. 2014; 34 (3): 658-71.
  9. Videla LA, Fernandez V, Vargas R, Cornejo P, Tapia G, Varela N, Valenzuela R, et al. Upregulation of rat liver PPARalphaFGF21 signaling by a docosahexaenoic acid and thyroid hormone combined protocol. Biofactors. 2016 Nov 12; 42 (6): 638-46.
  10. Lin Z, Pan X, Wu F, Ye D, Zhang Y, Wang Y, Jin L, Lian Q, et al. Fibroblast growth factor 21 prevents atherosclerosis by suppression of hepatic sterol regulatory element-binding protein-2 and induction of adiponectin in mice. Circulation. 2015; 131 (21): 1861-71.
  11. Lin Z, Tian H, Lam KS, Lin S, Hoo RC, Konishi M, Itoh N, Wang Y, Bornstein SR, Xu A, Li X. Lam Adiponectin mediates the metabolic effects of FGF21 on glucose homeostasis and insulin sensitivity in mice. Cell Metab. 2013 May 7; 17 (5): 779-89.
  12. Dutchak PA, Katafuchi T, Bookout AL, Choi JH, Yu RT, Mangelsdorf DJ, Kliewer SA. Bookout Fibroblast growth factor-21 regulates PPARgamma activity and the antidiabetic actions of thiazolidinediones. Cell. 2012 Feb 3; 148 (3): 556-67.
  13. Singhal G, Fisher FM, Chee MJ, Tan TG, El Ouaamari A, Adams AC, Najarian R, et al. Fibroblast growth factor 21 (FGF21) protects against high fat diet induced inflammation and islet hyperplasia in pancreas. PLoS One. 2016 Feb 12; 11 (2): e0148252.
  14. Gaich G, Chien JY, Fu H, Glass LC, Deeg MA, Holland WL, Kharitonenkov A, Bumol T, Schilske HK, Moller DE. The effects of LY2405319, an FGF21 analog, in obese human subjects with type 2 diabetes. Cell Metab. 2013 Sep 3; 18 (3): 333-40.
  15. Fisher FM, Chui PC, Antonellis PJ, Bina HA, Kharitonenkov A, Flier JS, Maratos-Flier E. Obesity is a fibroblast growth factor 21 (FGF21)-resistant state. Diabetes. 2010 Nov; 59 (11): 2781-9.
  16. Muise ES, Azzolina B, Kuo DW, El-Sherbeini M, Tan Y, Yuan X, Mu J, Thompson JR, Berger JP, Wong KK. Adipose fibroblast growth factor 21 is up-regulated by peroxisome proliferator-activated receptor gamma and altered metabolic states. Mol Pharmacol. 2008 Aug; 74 (2): 403-12.
  17. Samson SL, Sathyanarayana P, Jogi M, Gonzalez EV, Gutierrez A, Krishnamurthy R, Muthupillai R, Chan L, Bajaj M. Exenatide decreases hepatic fibroblast growth factor 21 resistance in non-alcoholic fatty liver disease in a mouse model of obesity and in a randomised controlled trial. Diabetologia. 2011 Dec; 54 (12): 3093-100.
  18. Li X, Fan X, Ren F, Zhang Y, Shen C, Ren G, Sun J, Zhang N, Wang W, Ning G, Yang J. Serum FGF21 levels are increased in newly diagnosed type 2 diabetes with nonalcoholic fatty liver disease and associated with hsCRP levels independently. Diabetes Res Clin Pract. 2011 Jul; 93 (1): 10-6.
  19. Yan H, Xia M, Chang X, Xu Q, Bian H, Zeng M, Rao S, Yao X, Tu Y, Jia W, Gao X. Circulating fibroblast growth factor 21 levels are closely associated with hepatic fat content: Cross-Sectional Study. PLoS One. 2011; 6 (9): e24895.
  20. Yilmaz Y, Eren F, Yonal O, Kurt R, Aktas B, Celikel CA, Ozdogan O, Imeryuz N, Kalayci C, Avsar E. Increased serum FGF21 levels in patients with nonalcoholic fatty liver disease. Eur J Clin Invest. 2010 Oct; 40 (10): 887-92.