Abstract: FR-PO505

Association between Circulating Fibroblast Growth Factor 21 and Body Composition in CKD

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 304 CKD: Epidemiology, Outcomes - Non-Cardiovascular

Authors

  • Okada, Mari, Jichi Medical University, Shimotsuke, Tochigi, Japan
  • Myoga, Hiroaki, Jichi Medical University, Shimotsuke, Tochigi, Japan
  • Shuto, Miwa, Jichi Medical University, Shimotsuke, Tochigi, Japan
  • Watanabe, Yuko, Jichi Medical University, Shimotsuke, Tochigi, Japan
  • Saito, Osamu, Jichi Medical University, Shimotsuke, Tochigi, Japan
  • Akimoto, Tetsu, Jichi Medical University, Shimotsuke, Tochigi, Japan
  • Muto, Shigeaki, Jichi Medical University, Shimotsuke, Tochigi, 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
  • Yoshizawa, Hiromichi, Jichi Medical University, Shimotsuke, Tochigi, Japan
  • Miki, Atsushi, Jichi Medical University, Shimotsuke, Tochigi, Japan
  • Nakagawa, Saki, Jichi Medical University, Shimotsuke, Tochigi, Japan
  • Ohara, Ken, Jichi Medical University, Shimotsuke, Tochigi, Japan
  • Murakami, Takuya, Jichi Medical University, Shimotsuke, Tochigi, Japan
  • Hishida, Erika, Jichi Medical University, Shimotsuke, Tochigi, Japan
Background

Fibroblast growth factor 21 (FGF21) is a liver-derived hormone that induces responses to stress including activation of the sympathetic nervous system and the hypothalamus-pituitary-adrenal axis. Circulating FGF21 levels increase in the progression of chronic kidney disease (CKD), but the mechanism has not yet been fully evaluated. In this study, we examined the association between circulating FGF21 and body composition in predialysis CKD patients.

Methods

Seventy-two predialysis CKD patients were enrolled in this study (age 51.3 ± 17.1 years, male 51.4%, estimated glomerular filtration rate [eGFR] 66.3 ± 28.3 ml/min/1.73m2). Body composition was measured by bioelectrical impedance analysis (BIA). Patients were divided 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 body composition.

Results

The median value of serum FGF21 was 131 pg/mL. Age (56.7 ± 15.4* vs. 45.2 ± 17.0 years, *p <0.05), body mass index (BMI) (26.1 ± 5.7* vs. 23.7 ± 4.3 kg/m2), systolic blood pressure 133 ± 16* vs. 122 ± 27 mmHg), extracellular water (ECW) (22.0 ± 5.2 vs. 21.2 ± 4.4 L, p=0.06), the ratio of ECW to total body water (ECW/TBW) (0.387 ± 0.021* vs. 0.376 ± 0.023) were high, eGFR (55.2 ± 27.0* vs. 79.2 ± 24.5 ml/min/1.73m2) and serum albumin (3.2 ± 0.9* vs. 3.8 ± 0.7 g/dL) were low in the high-FGF21. On the other hand, percentage of fat mass (26.6 ± 10.6 vs. 25.1 ± 9.3 %, p=0.264) and skeletal muscle (26.7 ± 6.8 vs. 25.7 ± 5.8 kg, p=0.264) were similar among the groups. In logistic regression analysis, ECW/TBW was an independent risk factor for higher FGF21 level (odds ratio 1.38: 95% confidence interval 1.04-1.96, p=0.024) even after adjustment for gender, BMI, systolic blood pressure, and percentage of fat mass.

Conclusion

In predialysis CKD patients, higher circulating FGF21 level is associated with increase in ECW/TBW. This result indicates that fluid retention is a novel indicator for circulating FGF21 levels.

Funding

  • Government Support - Non-U.S.