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Fibroblast Growth Factor 21 Predicts and Promotes Vascular Calcification in Haemodialysis Patients

Liqiong Jiang1,2, Qing Yin1, Min Yang3

  • 1Institute of Nephrology, Zhong Da Hospital, Southeast University School of Medicine, Nanjing, China.

Kidney Diseases (Basel, Switzerland)
|June 28, 2021
PubMed

Insights

Fibroblast growth factor 21 (FGF21) is significantly elevated in hemodialysis patients and strongly predicts vascular calcification (VC). FGF21 also promotes VC by increasing calcium deposition and endothelial-to-mesenchymal transition.

Area of Science:

  • Endocrinology
  • Nephrology
  • Cardiovascular Medicine

Background:

  • Cardiovascular disease (CVD) is the primary cause of mortality in hemodialysis (HD) patients.
  • Vascular calcification (VC) is accelerated in HD patients, correlating with CVD events and mortality.
  • Fibroblast growth factor 21 (FGF21) is a novel hypoglycemic adipocytokine inversely related to bone mineral density.

Purpose of the Study:

  • To investigate the association between FGF21 and vascular calcification (VC) in hemodialysis (HD) patients.
  • To evaluate FGF21's role in promoting VC in vitro.

Main Methods:

  • Cross-sectional study measuring serum FGF21 and thoracic aorta calcification scores (TACS) in HD patients.
  • In vitro experiments using human aortic endothelial cells (HAECs) treated with FGF21 and parathyroid hormone (PTH).

Main Results:

  • HD patients exhibited 11-fold higher FGF21 levels than controls.
  • Serum FGF21 positively correlated with TACS and its segments (ATACS, AoACS, DTACS) and was an independent predictor of VC.
  • FGF21, combined with age, calcium, and PTH, achieved high predictive value for VC (AUC 0.84).
  • In vitro, FGF21 enhanced PTH-induced calcification in HAECs via increased calcium deposition and endothelial-to-mesenchymal transition.

Conclusions:

  • Elevated circulating FGF21 is a significant finding in HD patients.
  • FGF21 acts as a potential predictor and promoter of vascular calcification in HD patients.
Abstract

Keywords:
Endothelial-to-mesenchymal transitionFibroblast growth factor 21HaemodialysisVascular calcification

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