Affiliation:
1. Kyung Hee University School of Medicine, Kyung Hee University Medical Center
2. Yeungnam University Medical Center
3. CHA University
4. Veterans Health Service Medical Center
5. Korea University College of Medicine
Abstract
Abstract
Follistatin-like protein-1 (FSTL-1) is secreted glycoprotein, which regulates cardiovascular, immune and skeletal system. However, the clinical significance of circulating FSTL-1 levels remains unclear in hemodialysis patients. A total 376 hemodialysis patients were prospectively enrolled from June 2016 to March 2020. Plasma FSTL-1 level, inflammatory biomarkers, physical performance, and echocardiographic findings at baseline were examined. The primary endpoint was defined as a composite of incident CV events and death. Plasma FSTL-1 levels were positively correlated with TNF-α and MCP-1. Handgrip strength showed weak positive correlation in male patients only. In multivariate linear regression analysis, FSTL-1 level was negatively associated with left ventricular ejection fraction (β = −0.36; p = 0.011). Both cumulative event rate of the composite of CV event and death, and cumulative event rate of CV events were significantly greater in FSTL-1 tertile 3. In Cox regression analysis, FSTL-1 tertile 3 was associated with a 1.80-fold risk for the composite of CV events and death(95% confidence interval (CI), 1.06–3.08), and a 2.29-fold risk for CV events (95% CI, 1.15–4.54) after adjustment for multiple variables. In conclusion, high circulating FSTL-1 levels independently predict the composite of CV events and death, and FSTL-1 level was independently associated with left ventricular systolic dysfunction.
Publisher
Research Square Platform LLC