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Circulating Fibroblast Growth Factor-21 Levels in Rheumatoid Arthritis: Associations With Disease Characteristics, Body Composition, and Physical Functioning
- Source :
- J Rheumatol
- Publication Year :
- 2020
- Publisher :
- The Journal of Rheumatology, 2020.
-
Abstract
- ObjectiveThis study evaluated associations between fibroblast growth factor (FGF)-21, an adipokine associated with metabolic stress, and adverse longitudinal changes in body composition and physical functioning in patients with rheumatoid arthritis (RA).MethodsAt baseline and follow-up, patients with RA aged 18–70 years completed whole-body dual-energy X-ray absorptiometry and peripheral quantitative computed tomography to quantify lean mass, fat mass, and muscle density. Dynamometry assessed muscle strength at the hand and knee, and physical functioning was measured with the Health Assessment Questionnaire (HAQ) and the Short Physical Performance Battery (SPPB). FGF-21 and inflammatory cytokines were measured at baseline. Linear and logistic regression analyses assessed associations between FGF-21 levels and both body composition and physical functioning over time.ResultsThere were 113 patients with RA enrolled, and 84 (74%) returned for follow-up at a median of 2.68 years. At baseline, FGF-21 was associated with age, smoking, methotrexate use, adiposity, and inflammatory cytokines: tumor necrosis factor receptor type I, YKL-40, vascular endothelial growth factor (VEGF), and resistin. The highest FGF-21 quartile was associated with worse SPPB and HAQ. Higher baseline FGF-21 levels (per 1 SD) were associated with worsening in muscle density and area Z-scores (β –0.06, 95% CI –0.12 to 0.008, P = 0.08; and β –0.05, 95% CI –0.10 to 0.006, P = 0.08, respectively) and a greater probability of a clinically meaningful worsening of HAQ (OR 2.37, 95% CI 1.21–4.64, P = 0.01). The fourth FGF-21 quartile was associated with worsening of SPPB (β –0.57, 95% CI –1.04 to –0.09, P = 0.02).ConclusionFGF-21 levels are associated with obesity and inflammatory cytokines, and with worsening in physical functioning in RA. These data support the hypothesis that FGF-21 can identify patients at risk of functional decline.
- Subjects :
- Vascular Endothelial Growth Factor A
0301 basic medicine
medicine.medical_specialty
FGF21
Immunology
Adipokine
Gastroenterology
Article
Proinflammatory cytokine
Arthritis, Rheumatoid
03 medical and health sciences
0302 clinical medicine
Rheumatology
Internal medicine
medicine
Humans
Immunology and Allergy
030203 arthritis & rheumatology
business.industry
medicine.disease
Obesity
Fibroblast Growth Factors
030104 developmental biology
Quartile
Rheumatoid arthritis
Body Composition
Lean body mass
Resistin
business
Subjects
Details
- ISSN :
- 14992752 and 0315162X
- Volume :
- 48
- Database :
- OpenAIRE
- Journal :
- The Journal of Rheumatology
- Accession number :
- edsair.doi.dedup.....1940316800066ee5e59b5b22aa6200a3