Endocrine Abstracts

Introduction: The course of type 2 diabetes (DM2) is linked with increased fibroblast growth factor 21 (FGF21) concentrations, however little information is available on the prognostic significance of FGF21 in DM2. The aim of the study was to assess whether FGF21 may be a predictor of cardiovascular (CV) events in patients with DM2.

Patients and methods: The study comprised 87 patients with DM2, aged 57–66 years, with the median duration of diabetes of 10 years, who were referred to the Department of Endocrinology for routine annual metabolic assessment. All the patients underwent clinical and laboratory assessment at the time of enrolment; next, the study group was observed prospectively during the period of 24 months. Serum FGF21 levels were assessed with ‘Human FGF21 ELISA’ BioVendor. During a follow-up, overall mortality, CV mortality, and CV nonfatal events were registered. Cox proportional hazards regression assessed adjusted differences in CV morbidity and mortality risk.

Results: Patients were stratified according to serum FGF21 levels less than or equal to and greater than the median value of 240.7 pg/ml. The groups showed no significant differences at baseline in gender distribution, diabetes duration, insulin therapy, BMI, biochemical profiles and previous CV events. At 24-month follow-up, 21 (24.1%) patients experienced a nonfatal CV event. A significantly (P=0.0013) higher incidence of the combined end point of CV morbidity and mortality was observed in the FGF21 >240.7 pg/ml group. In the multivariate Cox proportional hazards regression model, the presence of FGF21 greater than the median value was associated with a significant increase in the risk of the combined end point of CV morbidity and mortality (HR: 4.7, 95% CI 1.67–13.24).

Conclusion: The increased FGF21 concentrations may serve as a predictor of CV events and provide a useful tool for stratification of prognosis in DM2 patients.