ECE2016 Eposter Presentations Cardiovascular Endocrinology and Lipid Metabolism (51 abstracts)
Natural history and metabolic implications of the new hormone fibroblast growth factor 21 in uremic patients on peritoneal dialysis
Juan J Díez 1 , Elena González 2 , María Auxiliadora Bajo 2 , Gloria Del Peso 2 , Cristina Grande 3 , Olaia Rodríguez 3 , Mariana Díaz-Almirón 4 , Pedro Iglesiaas 1 & Rafael Selgas 2
1Department of Endocrinology, Hospital Universitario Ramón y Cajal, Madrid, Spain; 2Department of Nephrology, Hospital Universitario La Paz, Madrid, Spain; 3Department of Biochemistry, Hospital Universitario La Paz, Madrid, Spain; 4Department of Biostatistics, Hospital Universitario La Paz, Madrid, Spain.
Background: Human fibroblast growth factor 21 (FGF21) is a new liver hormone that stimulate adipocyte glucose uptake and is involved in regulation of body fat.
Objective: To define the natural history of FGF21 in peritoneal dialysis (PD) patients and analyze its relationship with glucose metabolism, peritoneal function, and residual renal function (RRF).
Methods: We studied 48 uremic patients undergoing PD. Patients were evaluated at baseline, and 1, 2 and 3 years after starting PD. At each evaluation, clinical status, biochemical parameters (including FGF21, glucose, insulin, homeostatic model assessment of insulin resistance index (HOMA-IR) and non-esterified fatty acids concentration (NEFA)), and peritoneal function parameters were assessed.
Results: Plasma FGF21 concentrations significantly increased over the first year and maintained at high levels during the rest of the study period, especially among non-diabetic patients (n=37, baseline 253 (59–685) vs 647 (121–1117) pg/ml at third year, P<0.01). In non-diabetic patients glucose levels did not modify, whereas HOMA-IR showed a significant reduction at second year (1.96 (1.23–4.15) vs 1.65 (0.79–2.86), P<0.01). Baseline FGF21 concentrations significantly correlated with RRF (ρ=−0.484, P<0.05) and peritoneal protein losses (PPL, ρ=0.410, P<0.05). Using a mixed model analysis, we found a positive correlation between time on dialysis and FGF21 levels (P<0.001). There was no association between FGF21 levels and age, body mass index, HOMA-IR, NEFA, glucose, glucose load from PD solutions, and peritoneal mass transfer coefficients of urea and creatinine. Patients with RRF had significantly (P<0.05) lower levels of FGF21 than those without it, and there was a significant positive association between FGF21 levels and PPL (P<0.05), independently of the time on dialysis.
Conclusion: FGF21 plasma levels importantly increase during PD therapy. This increment is associated with RRF and PPL. The absence of increment in insulin resistance in spite of maintained peritoneal glucose load suggests that FGF-21 might behave as a protective factor against insulin resistance.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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