Increased Fibroblast Growth Factor-21 is associated with metabolic syndrome in people with chronic spinal cord injury : a cross-sectional study

Objective: To investigate the association between plasma fibroblast growth factor 21 (FGF21) and conventional metabolic parameters in people with chronic spinal cord injury (SCI). Design: A cross-sectional study Setting: An SCI-specialized rehabilitation facility in a university hospital Participants: Fifty-six participants with chronic SCI (duration of SCI ≥ 1 year) Intervention: Not applicable Main Outcome Measure: After informed consent, demographic and SCI-related parameters were collected. Metabolic parameters, including anthropometric measures, body composition assessed by dual-energy x-ray absorptiometry, and blood tests, were evaluated. Plasma FGF21 levels were determined using an enzyme-linked immunosorbent assay (ELISA) method. Metabolic syndrome was diagnosed by the American Heart Association (AHA)/the National Cholesterol Education Program (NCEP) III Criteria. Associations between plasma FGF21 levels and other parameters were determined using multivariable linear regression analyses. Results: Among 56 participants, 37 people (66%) were male. The mean (SD) age was 43.8 (10.6) years. Twelve people (21%) had tetraplegia and 14 people (15%) had complete SCI. Twelve (21%) participants were diagnosed with obesity, prediabetes, and metabolic syndrome (MetS). Using multivariable analysis adjusting for all demographic data, medical conditions, and metabolic parameters, being diagnosed with MetS had an independent positive association with plasma FGF21 level (P = 0.020, Beta coefficient = 0.776 [95%CI: 0.126–1.426]; multivariable linear regression analysis) Conclusions: In people with chronic SCI, MetS is an independent positive associated factor of plasma FGF21 level, which may suggest the presence of FGF21-resistant condition. This result addresses the interesting role of FGF21 in the development of cardiometabolic diseases in people with chronic SCI.