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.
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