Abstract: SA-PO188

Nocturnal Intermittent Hypoxia Is Associated with Elevated Circulating Fibroblast Growth Factor 21 in ESRD

Session Information

Category: Nutrition, Inflammation, and Metabolism

  • 1401 Nutrition, Inflammation, Metabolism

Authors

  • Murakami, Takuya, Jichi Medical University , Shimotsuke, Tochigi, Japan
  • Asano, Yasushi, Japanese Red Cross Koga Hospital, Koga, Ibaraki, Japan
  • Kuro-o, Makoto, Jichi Medical University, Shimotsuke, Tochigi, Japan
  • Nagata, Daisuke, Jichi Medical University , Shimotsuke, Tochigi, Japan
  • Masuda, Takahiro, Jichi Medical University , Shimotsuke, Tochigi, Japan
  • Kohara, Marina, Jichi Medical University , Shimotsuke, Tochigi, Japan
  • Shiizaki, Kazuhiro, Jichi Medical University, Shimotsuke, Tochigi, Japan
  • Akimoto, Tetsu, Jichi Medical University , Shimotsuke, Tochigi, Japan
  • Honma, Sumiko, Japanese Red Cross Koga Hospital, Koga, Ibaraki, Japan
  • Watanabe, Yuko, Jichi Medical University , Shimotsuke, Tochigi, Japan
  • Saito, Osamu, Jichi Medical University , Shimotsuke, Tochigi, Japan
  • Kusano, Eiji, JCHO Utsunomiya Hospital, Shimotsuke, Tochigi, Japan
Background

Fibroblast growth factor (FGF) 21 is an endocrine factor mainly produced in the liver in response to various stress including inflammation and oxidative stress. We recently reported that higher circulating FGF21 predicts all-cause mortality in end-stage renal disease (ESRD) (Kohara M et al. PLoS One 2017), but the regulator to increase circulating FGF21 remains unclear. We therefore examined the association between circulating FGF21 and sleep-disordered breathing (SDB), characterized by nocturnal intermittent hypoxia and a mediator for chronic inflammation in ESRD.

Methods

Sixty-three ESRD patients receiving maintenance hemodialysis (age 64.2 ± 13.0 years, male 50.8%) were enrolled in this study. Overnight pulse oximetry was performed on a dialysis day, and numbers of over 3% desaturation per hour were defined as the 3% oxygen desaturation index (3%ODI). Patients were categorized into low- and high-FGF21 groups by the median value. Multivariable logistic regression analysis was used to examine the association between serum FGF21 levels and 3%ODI.

Results

The median value of serum FGF21 was 2021 pg/mL. The 3%ODI (6.8 ± 0.9 vs. 3.8 ± 1.0 times/hour, p=0.023) and the percentage of male (63.6 vs. 36.7 %, p=0.031) were significantly higher in the high-FGF21 group than in the low-FGF21 group. On the other hand, the mean oxygen saturation at night did not differ between the two groups (96.2 ± 1.6 vs. 96.4 ± 1.6 %, p=0.34). The 3%ODI was an independent risk factor for higher serum FGF21 levels (odds ratio 1.16: 95% confidence interval: 1.01-1.36, p=0.028) even after adjustment for age, gender, duration of dialysis and presence of diabetes.

Conclusion

Nocturnal intermittent hypoxia, but not mean oxygen saturation, is associated with elevated circulating FGF21 in ESRD. This result suggests that SDB is a novel therapeutic target for regulating circulating FGF21 levels.

Funding

  • Private Foundation Support