Circulating Fibroblast Growth Factor-21 and Risk of Metachronous Colorectal Adenoma
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ORIGINAL RESEARCH
Circulating Fibroblast Growth Factor-21 and Risk of Metachronous Colorectal Adenoma Ana Florea 1,2 & Robin B. Harris 1 & Yann C. Klimentidis 1 & Lindsay N. Kohler 1,3 & Peter W. Jurutka 4,5 & Elizabeth T. Jacobs 1 Accepted: 7 September 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose Prior work has shown that higher circulating concentrations of fibroblast growth factor-21 (FGF-21) are associated with an increased likelihood of developing colorectal cancer. We conducted a prospective study to assess the relationship between circulating FGF-21 and odds of developing early neoplastic lesions in the colorectum. Methods A total of 94 study participants were included from the ursodeoxycholic acid (UDCA) trial, a phase III, randomized, doubleblind, placebo-controlled clinical trial of the effect of 8–10 mg/kg of body weight UDCA vs. placebo. Logistic regression analyses were conducted to evaluate the association between baseline FGF-21 concentrations and odds of developing a metachronous adenoma. Results Of the characteristics compared across tertiles of FGF-21 concentrations, including age, race, sex, BMI, and other variables, only a previous personal history of colorectal polyps prior to entry into the UDCA trial was statistically significantly related to FGF-21 levels, with a proportion of 26.7%, 56.7%, and 50.0% across the first, second, and third tertiles, respectively (p < 0.05). Higher circulating concentrations of FGF-21 were statistically significantly associated with greater odds of developing a metachronous colorectal adenoma. After adjusting for potential confounders and when compared with the lowest tertile of FGF21, the adjusted ORs (95% CIs) for metachronous colorectal adenoma in the second and third tertiles were 4.72 (95% CI, 1.42– 15.72) and 3.82 (95% CI, 1.15–12.68), respectively (p trend < 0.05). Conclusion Our results reveal for the first time that, in addition to a recently discovered association with colorectal cancer, circulating FGF-21 concentrations are significantly and directly associated with odds of developing metachronous colorectal adenoma. Keywords Fibroblast growth factor-21 . FGF-21 . Colorectal adenoma . Colorectal cancer
Introduction In the USA, colorectal cancer (CRC) is the third most common cancer diagnosed in men and women combined [1, 2]. In
* Ana Florea [email protected] 1
Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
2
Department of Medicine, Division of Nephrology, College of Medicine, University of Arizona, Tucson, AZ, USA
3
Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
4
School of Mathematical and Natural Sciences, Arizona State University, Glendale, AZ, USA
5
Department of Basic Medical Sciences, University of Arizona College of Medicine, Phoenix, AZ, USA
2020, 147,950 new cases of CRC are expected to occur [1]. Although incidence
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