Serum Fibroblast Growth Factor 21 as a Novel Biomarker in Prediction of Coronary Artery Disease Severity
Mervat M. Khalaf *
Department of Critical Care Medicine, Faculty of Medicine, Cairo University, Egypt.
Salwa Fayez
Department of Medical Biochemistry, Faculty of Medicine, Cairo University, Egypt.
Taha Azouz
Department of Medical Biochemistry, Faculty of Medicine, Cairo University, Egypt.
*Author to whom correspondence should be addressed.
Abstract
Aims: To evaluate serum FGF-21 concentrations in coronary heart disease patients (CHD) whether or not associated with diabetes and/or hypertension. It also investigated the possible association between serum FGF21 and the coronary angiographic findings in terms of number of coronary vessels affected.
Study Design: Cross-sectional observational comparative study.
Place and Duration of Study: Coronary angiography unit at the Critical Care Department with Biochemistry Department, Kasr Al Aini Medical Hospitals, from January 2013 to March 2014.
Methods: Seventy patients (47 Males and 23 females) were classified after coronary angiography into: Sub-group (A): Coronary Artery Disease patients without DM or hypertension; Sub-group (B): Coronary Artery Disease patients with DM and/or hypertension; Sub-group (C): Patients with normal angiography but suffering from DM and/ or hypertension. Twelve healthy individuals were also included in the present study as a control group. Body Mass Index (BMI) were matched for all groups, systolic and diastolic blood pressure (SBP&DBP) and fasting serum levels of FGF21, glucose, insulin and lipid profile were estimated.
Results: A significant increase in the levels of FGF-21 was detected in CHD patients compared to control group (325.8 ± 129.2 Vs 202.2 ± 65.8, P =.002) and significant increase was also found in those with multi-vessel disease affection compared to those with one-vessel affection group (392.1 ± 140.4 Vs 250.7 ± 83.8, P=.007), There was a highly significant positive correlation between serum levels of FGF-21 and each of BMI (r= .7, P > .001), SBP (r= .63, P > .001), and DBP (r= .67, P > .001). ROC curve analysis indicated that the optimum cut off value for plasma FGF 21 level in patients with CHD versus control was 236 pg/ml which gives 68.33% sensitivity and 75% specificity.
Conclusion: Circulating FGF21 level could be a biomarker for CHD and may be used for assessment of severity of CHD.
Keywords: FGF 21, CHD, BMI, metabolic syndrome and type 2 DM.