Circulating Fibroblast Growth Factor-21 Levels in Rheumatoid Arthritis: Associations With Disease Characteristics, Body Composition, and Physical Functioning.

Autor:	Gould PW; P.W. Gould, BA, E.G. Taratuta, MD, Perelman School of Medicine, University of Pennsylvania., Zemel BS; B.S. Zemel, PhD, Perelman School of Medicine, University of Pennsylvania, and Children's Hospital of Philadelphia., Taratuta EG; P.W. Gould, BA, E.G. Taratuta, MD, Perelman School of Medicine, University of Pennsylvania., Baker JF; J.F. Baker, MD, MSCE, Perelman School of Medicine, University of Pennsylvania, Philadelphia VA Medical Center, Division of Rheumatology, University of Pennsylvania, and Department of Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania, USA. Joshua.Baker@pennmedicine.upenn.edu.
Jazyk:	angličtina
Zdroj:	The Journal of rheumatology [J Rheumatol] 2021 Apr; Vol. 48 (4), pp. 504-512. Date of Electronic Publication: 2020 Nov 01.
DOI:	10.3899/jrheum.200673
Abstrakt:	Objective: This 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). Methods: At 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. Results: There 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). Conclusion: FGF-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. (Copyright © 2021 by the Journal of Rheumatology.)
Databáze:	MEDLINE
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