FGF21 Can Help Predicting Arterial Stiffness Measured by Cardio-ankle Vascular Index in Renal Transplant Patients

Vascular Stiffness Clinical Trial

— CAVIFGF21  

Official title:

FGF21 Can Help Predicting Arterial Stiffness Measured by Cardio-ankle Vascular Index in Renal Transplant Patients

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02704468
• Other study ID #: 085/58
• Status: Completed
• Phase: N/A
• First received: February 29, 2016
• Last updated: July 18, 2016
• Start date: January 2016
• Est. completion date: July 2016

Study information

• Verified date: July 2016
• Source: Bangkok Metropolitan Administration Medical College and Vajira Hospital
• Contact: n/a
• Is FDA regulated: No
• Health authority: Thailand: Ethical Committee
• Study type: Observational [Patient Registry]

Clinical Trial Summary

Chronic kidney disease(CKD) patients have high incidence of coronary artery problems event after renal transplantation. And remain a major cause of mortality. The major risk marker is arterial stiffness. The cardio-ankle vascular index (CAVI) is a new index of overall stiffness and can estimated the risk of atherosclerosis.

Fibroblast growth factor 21 (FGF-21) is a metabolic regulator that plays important role in cardiac remodeling elevated FGF-21 have been reported in coronary heart disease or carotid artery plaque and could be biomarkers for atherosclerosis disease Investigators aimed to study the association between CAVI and FGF-21 and their relations to various parameters that can contribute to cardiovascular disease eg. homocysteine Echocardiogram findings and other traditional basic factors.

Description:

A total of 90 participants who underwent renal transplant were included in the study. The following measures were done and laboratory data were collected. CAVI, Ecchocariogram, Homocysteine, Hs-CRP, Carotid IMT, FGF-21, Medication after renal transplantation, incidence of cardiovascular disease correlation between categorical data was done by using Pearson's correlation test and multiple regression analysis.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 100
• Est. completion date: July 2016
• Est. primary completion date: July 2016
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: Both
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• renal transplant patients patients for more than 1 month

Exclusion Criteria:

• who had contraindication for CAVI

• current smoker

• eGFR <15 ml/min/173

• cardiac arrthymia

Study Design

Time Perspective: Cross-Sectional

Related Conditions & MeSH terms

• Vascular Stiffness

Intervention

Other:
• CAVI and FGF-21
FGf-21 and CAVI was measured in renal transplant patients group and study correlation with arterial stiffness

Locations

Country	Name	City	State
Thailand	Bangkok metropolitan administraiton of vajira hospital	Bangkok

Sponsors (1)

Lead Sponsor	Collaborator
Bangkok Metropolitan Administration Medical College and Vajira Hospital

Country where clinical trial is conducted

Thailand, 

References & Publications (27)

An SY, Lee MS, Yi SA, Ha ES, Han SJ, Kim HJ, Kim DJ, Lee KW. Serum fibroblast growth factor 21 was elevated in subjects with type 2 diabetes mellitus and was associated with the presence of carotid artery plaques. Diabetes Res Clin Pract. 2012 May;96(2):196-203. doi: 10.1016/j.diabres.2012.01.004. Epub 2012 Jan 30. — View Citation

Chen YC, Lee MC, Lee CJ, Ho GJ, Yin WY, Chang YJ, Hsu BG. N-terminal pro-B-type natriuretic peptide is associated with arterial stiffness measured using the cardio-ankle vascular index in renal transplant recipients. J Atheroscler Thromb. 2013;20(7):646-53. Epub 2013 May 10. — View Citation

Cheng HM, Chuang SY, Sung SH, Yu WC, Pearson A, Lakatta EG, Pan WH, Chen CH. Derivation and validation of diagnostic thresholds for central blood pressure measurements based on long-term cardiovascular risks. J Am Coll Cardiol. 2013 Nov 5;62(19):1780-7. doi: 10.1016/j.jacc.2013.06.029. Epub 2013 Jul 10. — View Citation

Chow WS, Xu A, Woo YC, Tso AW, Cheung SC, Fong CH, Tse HF, Chau MT, Cheung BM, Lam KS. Serum fibroblast growth factor-21 levels are associated with carotid atherosclerosis independent of established cardiovascular risk factors. Arterioscler Thromb Vasc Biol. 2013 Oct;33(10):2454-9. doi: 10.1161/ATVBAHA.113.301599. Epub 2013 Jul 25. — View Citation

Coskun T, Bina HA, Schneider MA, Dunbar JD, Hu CC, Chen Y, Moller DE, Kharitonenkov A. Fibroblast growth factor 21 corrects obesity in mice. Endocrinology. 2008 Dec;149(12):6018-27. doi: 10.1210/en.2008-0816. Epub 2008 Aug 7. — View Citation

Deo R, Shou H, Soliman EZ, Yang W, Arkin JM, Zhang X, Townsend RR, Go AS, Shlipak MG, Feldman HI. Electrocardiographic Measures and Prediction of Cardiovascular and Noncardiovascular Death in CKD. J Am Soc Nephrol. 2016 Feb;27(2):559-69. doi: 10.1681/ASN.2014101045. Epub 2015 Jul 9. — View Citation

Dobsak P, Soska V, Sochor O, Jarkovsky J, Novakova M, Homolka M, Soucek M, Palanova P, Lopez-Jimenez F, Shirai K. Increased cardio-ankle vascular index in hyperlipidemic patients without diabetes or hypertension. J Atheroscler Thromb. 2015;22(3):272-83. doi: 10.5551/jat.24851. Epub 2014 Oct 22. — View Citation

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Jin K, LaFevre-Bernt M, Sun Y, Chen S, Gafni J, Crippen D, Logvinova A, Ross CA, Greenberg DA, Ellerby LM. FGF-2 promotes neurogenesis and neuroprotection and prolongs survival in a transgenic mouse model of Huntington's disease. Proc Natl Acad Sci U S A. 2005 Dec 13;102(50):18189-94. Epub 2005 Dec 2. — View Citation

Kharitonenkov A, Shiyanova TL, Koester A, Ford AM, Micanovic R, Galbreath EJ, Sandusky GE, Hammond LJ, Moyers JS, Owens RA, Gromada J, Brozinick JT, Hawkins ED, Wroblewski VJ, Li DS, Mehrbod F, Jaskunas SR, Shanafelt AB. FGF-21 as a novel metabolic regulator. J Clin Invest. 2005 Jun;115(6):1627-35. Epub 2005 May 2. — View Citation

Kharitonenkov A, Wroblewski VJ, Koester A, Chen YF, Clutinger CK, Tigno XT, Hansen BC, Shanafelt AB, Etgen GJ. The metabolic state of diabetic monkeys is regulated by fibroblast growth factor-21. Endocrinology. 2007 Feb;148(2):774-81. Epub 2006 Oct 26. — View Citation

Khoshdel AR, Carney SL. Arterial stiffness in kidney transplant recipients: an overview of methodology and applications. Urol J. 2008 Winter;5(1):3-14. Review. — View Citation

Kim KJ, Lee BW, Kim HM, Shin JY, Kang ES, Cha BS, Lee EJ, Lim SK, Lee HC. Associations between cardio-ankle vascular index and microvascular complications in type 2 diabetes mellitus patients. J Atheroscler Thromb. 2011;18(4):328-36. Epub 2011 Jan 6. — View Citation

KOTANI, K.; REMALEY, A. T. Cardio-AnkleVascular Index (CAVI) and its Potential Clinical Implications for Cardiovascular Disease. CardiolPharmacol, 2013, 2: 108.

Lee Y, Lim S, Hong ES, Kim JH, Moon MK, Chun EJ, Choi SI, Kim YB, Park YJ, Park KS, Jang HC, Choi SH. Serum FGF21 concentration is associated with hypertriglyceridaemia, hyperinsulinaemia and pericardial fat accumulation, independently of obesity, but not with current coronary artery status. Clin Endocrinol (Oxf). 2014 Jan;80(1):57-64. doi: 10.1111/cen.12134. Epub 2013 May 6. — View Citation

Lin Z, Wu Z, Yin X, Liu Y, Yan X, Lin S, Xiao J, Wang X, Feng W, Li X. Serum levels of FGF-21 are increased in coronary heart disease patients and are independently associated with adverse lipid profile. PLoS One. 2010 Dec 29;5(12):e15534. doi: 10.1371/journal.pone.0015534. — View Citation

Mahabadi AA, Massaro JM, Rosito GA, Levy D, Murabito JM, Wolf PA, O'Donnell CJ, Fox CS, Hoffmann U. Association of pericardial fat, intrathoracic fat, and visceral abdominal fat with cardiovascular disease burden: the Framingham Heart Study. Eur Heart J. 2009 Apr;30(7):850-6. doi: 10.1093/eurheartj/ehn573. Epub 2009 Jan 9. — View Citation

Mirza MA, Hansen T, Johansson L, Ahlström H, Larsson A, Lind L, Larsson TE. Relationship between circulating FGF23 and total body atherosclerosis in the community. Nephrol Dial Transplant. 2009 Oct;24(10):3125-31. doi: 10.1093/ndt/gfp205. Epub 2009 May 9. — View Citation

Ong KL, Januszewski AS, O'Connell R, Jenkins AJ, Xu A, Sullivan DR, Barter PJ, Hung WT, Scott RS, Taskinen MR, Keech AC, Rye KA. The relationship of fibroblast growth factor 21 with cardiovascular outcome events in the Fenofibrate Intervention and Event Lowering in Diabetes study. Diabetologia. 2015 Mar;58(3):464-73. doi: 10.1007/s00125-014-3458-7. Epub 2014 Nov 26. — View Citation

Otsuka K, Fukuda S, Shimada K, Suzuki K, Nakanishi K, Yoshiyama M, Yoshikawa J. Serial assessment of arterial stiffness by cardio-ankle vascular index for prediction of future cardiovascular events in patients with coronary artery disease. Hypertens Res. 2014 Nov;37(11):1014-20. doi: 10.1038/hr.2014.116. Epub 2014 Jul 10. — View Citation

Sarnak MJ, Levey AS, Schoolwerth AC, Coresh J, Culleton B, Hamm LL, McCullough PA, Kasiske BL, Kelepouris E, Klag MJ, Parfrey P, Pfeffer M, Raij L, Spinosa DJ, Wilson PW; American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention. Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention. Circulation. 2003 Oct 28;108(17):2154-69. Review. — View Citation

Semba RD, Crasto C, Strait J, Sun K, Schaumberg DA, Ferrucci L. Elevated serum fibroblast growth factor 21 is associated with hypertension in community-dwelling adults. J Hum Hypertens. 2013 Jun;27(6):397-9. doi: 10.1038/jhh.2012.52. Epub 2012 Nov 29. — View Citation

Shirai K, Hiruta N, Song M, Kurosu T, Suzuki J, Tomaru T, Miyashita Y, Saiki A, Takahashi M, Suzuki K, Takata M. Cardio-ankle vascular index (CAVI) as a novel indicator of arterial stiffness: theory, evidence and perspectives. J Atheroscler Thromb. 2011;18(11):924-38. Epub 2011 May 31. Review. — View Citation

Stehouwer CD, Henry RM, Ferreira I. Arterial stiffness in diabetes and the metabolic syndrome: a pathway to cardiovascular disease. Diabetologia. 2008 Apr;51(4):527-39. doi: 10.1007/s00125-007-0918-3. Epub 2008 Feb 1. Review. — View Citation

Sun CK. Cardio-ankle vascular index (CAVI) as an indicator of arterial stiffness. Integr Blood Press Control. 2013 Apr 30;6:27-38. doi: 10.2147/IBPC.S34423. Print 2013. — View Citation

Takaki A, Ogawa H, Wakeyama T, Iwami T, Kimura M, Hadano Y, Matsuda S, Miyazaki Y, Matsuda T, Hiratsuka A, Matsuzaki M. Cardio-ankle vascular index is a new noninvasive parameter of arterial stiffness. Circ J. 2007 Nov;71(11):1710-4. — View Citation

Verbeke F, Maréchal C, Van Laecke S, Van Biesen W, Devuyst O, Van Bortel LM, Jadoul M, Vanholder R. Aortic stiffness and central wave reflections predict outcome in renal transplant recipients. Hypertension. 2011 Nov;58(5):833-8. doi: 10.1161/HYPERTENSIONAHA.111.176594. Epub 2011 Sep 6. — View Citation

* Note: There are 27 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	association between CAVI and FGF-21 with arterial stiffness in renal transplant patients	cross sectional study	1 month	No
Secondary	association between Hs-CRP,Homocystein with CAVI	cross sectional study	1 month	No