Research Paper Advance Articles

Fibroblast growth factor 21 inversely correlates with survival in elderly population – the results of the Polsenior2 study

Gabriela Handzlik1, , Aleksander J. Owczarek2, , Andrzej Więcek3, , Małgorzata Mossakowska4, , Tomasz Zdrojewski5, , Anna Chudek2, , Magdalena Olszanecka-Glinianowicz2, , Jerzy Chudek1, ,

  • 1 Department of Internal Medicine and Oncological Chemotherapy, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
  • 2 Health Promotion and Obesity Management Unit, Department of Pathophysiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
  • 3 Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia, Katowice, Poland
  • 4 Study on Aging and Longevity, International Institute of Molecular and Cell Biology, Warsaw, Poland
  • 5 Division of Preventive Medicine and Education, Medical University of Gdansk, Gdansk, Poland

Received: February 1, 2024       Accepted: July 18, 2024       Published: September 18, 2024      

https://doi.org/10.18632/aging.206114
How to Cite

Copyright: © 2024 Handzlik et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Fibroblast growth factor 21 (FGF21) is a liver-secreted hormone involved in the regulation of lipid, glucose, and energy metabolism. Its serum concentration increases with age but also is higher in numerous diseases. FGF21 is being investigated for biomarker properties and as a potential therapeutic target. The present study aimed to assess the prognostic value of FGF21 in an older population-based cohort, the PolSenior2 study participants. In the sub-analysis of 3512 individuals, aged 60 and older, stratified according to FGF21 into tertiles, the survival estimate was worse in participants with middle and high levels compared to the lowest tertile. These results were consistent with univariable Cox regression analysis, in which participants in the middle and the high FGF21 tertiles after adjustment for age had 1.43-fold (HR, 1.31; 95% CI, 1.05 – 1.62) and 2.56-fold (HR, 1.94; 95% CI, 1.59 – 2.37) higher risk for mortality, respectively, compared with those in the lowest tertile. In multivariable Cox regression analysis, the highest levels of FGF21 were associated with increased mortality (HR 1.53; 95% CI, 1.22 – 1.92) independently of co-morbidities and blood parameters. These results indicate that higher serum FGF21 concentration is an independent predictor of all-cause mortality in the general population of older adults.

Abbreviations

BMI: body mass index; CAD: coronary artery disease; CKD-EPI: Chronic Kidney Disease Epidemiology Collaboration equation; DM: diabetes; eGFR: estimated glomerular filtration rate; FGF21: fibroblast growth factor 21; FIB-4: fibrosis 4 index; GFR: glomerular filtration rate; GLUT1: glucose transporter 1; HA: hypertension; HbA1c: hemoglobin A1c; HF: heart failure; HOMA-IR: homeostatic model assessment – insulin resistance; HR: hazard ratio; hs-CRP: high-sensitivity C-reactive protein; IFG: impaired fasting glucose.