Endocrine Abstracts

Introduction: Obesity and type 2 diabetes mellitus (T2DM) are associated with cardiovascular diseases (CVD). Fibrotic changes in obesity include several molecular processes, including activation of Transforming growth factor β (TGF-β). Recent data indicate the involvement of Fibroblast growth factor 21 (FGF-21) as an important metabolic regulator, and even biomarker of metabolic changes in obesity and T2DM.

Aim: To determine TGF-β and FGF-21 level in patients with obesity and T2DM.

Methods: TGF-β and FGF-21 were identified in peripheral blood of 66 patients, aged 48–65 years with obesity. They were divided into 3 groups. 1st – 21 patients with coronary heart disease (CHD) (confirmed by coronary angiography (CAG)) and T2DM, the 2nd – 22 patients with T2DM, in the 3rd – 23 patients without T2DM and CHD. CHD was excluded in the 2nd and 3rd groups by Tredmil test. Control (4th) group included 14 healthy person matched by age and sex.

Results: TGF-β was significantly different in the studied groups (P=0.046). We found that TGF-β was significantly lower in patients with CHD (group 1) compared with the group of “metabolically healthy” obesity (P=0.02). TGF-β negatively correlated with. atherogenic fractions of cholesterol – LDL (r=−0.426, P=0.043) and with the degree of internal carotid artery 0stenosis (r=−0.426, P=0.039) in patients with T2DM. In contrast, patients with verified CHD demonstrated a negative correlation with the duration of obesity (r=−0.395, P<0.033), and the processes of heart muscle remodeling (thickness of the left ventricular posterior wall (r=−0.386, P=0.029) and interventricular septum (r=−0.335, P=0.031). FGF-21 and TGF-β in the 1st group showed a negative correlation with the number of significantly affected vessels according to CAG (r=−0.73, P=0.041 and r=−0.52, P=0.036, respectively). All patients with obesity had significantly increased level of FGF-21 compared with the control group (P=0.03) and FGF-21 positively correlated with BMI (r=0.47, P=0.021)

Conclusions: 1. FGF-21 and TGF-β reduction were associated with CHD in patients with obesity.

2. Increased TGF-β may play a protective role in atherosclerosis in patients with diabetes and obesity.