Relationship of fibroblast growth factor 21 with subclinical atherosclerosis and cardiovascular events: Multi-Ethnic Study of Atherosclerosis

Kwok Leung Ong, Steven Campbell, Ben J. Wu, Robyn L. McClelland, John Kokkinos, Moyses Szklo, Joseph F. Polak, Matthew A. Allison, Kerry Anne Rye

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background and aims: Fibroblast growth factor 21 (FGF21) has been suggested as a novel biomarker for cardiovascular disease (CVD), especially in people with high CVD risk. However, it is not known whether FGF21 is a CVD biomarker in an initially healthy cohort. We therefore investigated the relationship of plasma FGF21 levels with measures of subclinical atherosclerosis and cardiovascular events in Multi-Ethnic Study of Atherosclerosis participants without known CVD at baseline. Methods: A total of 5788 participants had plasma FGF21 levels measured at the baseline exam (2000–2002). Carotid intima-media thickness (IMT), ankle-brachial index (ABI) and coronary artery calcification (CAC) were measured at baseline. Participants were followed up for incident CVD events over a median period of 14 years. Results: In cross-sectional analyses adjusting for socio-demographic variables, participants with higher FGF21 levels had higher carotid IMT, lower ABI, and higher prevalence of CAC (p < 0.001). However, these associations were not significant after simultaneously adjusting for demographic, socioeconomic and lifestyle factors, traditional CVD risk factors, and biomarkers of inflammation and hemostasis. Among 5768 patients with follow-up data, 820 developed incident CVD endpoints. Higher baseline FGF21 levels were not associated with the risk for incident CVD endpoints after adjusting for multiple confounding factors (odds ratio 1.03; 95% confidence interval, 0.94–1.12, per SD increase in ln-transformed FGF21 levels). Conclusions: Although FGF21 has been suggested as a CVD biomarker for people with high CVD risk, our findings do not support a role of FGF21 as a CVD biomarker in those without a history of CVD.

Original languageEnglish (US)
Pages (from-to)46-53
Number of pages8
StatePublished - Aug 2019


  • Ankle-brachial index
  • Cardiovascular disease
  • Carotid intima-media thickness
  • Coronary artery calcification
  • Fibroblast growth factor 21

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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