FGF-21 as a potential biomarker for coronary artery calcification: a non-invasive approach

Aims: The aim of this study was to investigate the relationship between fibroblast growth factor 21 (FGF-21) levels and coronary artery calcium (CAC) scores calculated using the Agatston method, and to evaluate the potential of FGF-21 as a non-invasive biomarker for the assessment of coronary artery calcification. Methods: A total of 54 adult individuals who had undergone coronary CT angiography within the past three months solely for cardiovascular risk assessment were prospectively included in the study. Serum FGF-21 levels were measured using the ELISA method, and CAC scores were determined via the Agatston scoring system. The relationship between FGF-21 levels and CAC scores was analyzed using Spearman’s correlation test. Results: A significant and strong positive correlation was observed between FGF-21 levels and CAC scores (r = 0.725, p < 0.001). Diabetes mellitus and hyperlipidemia were significantly associated with higher CAC scores (p = 0.006 and p = 0.024, respectively), whereas their associations with FGF-21 levels were not statistically significant (p = 0.065 and p = 0.104). No significant correlations were found between FGF-21 levels and other variables such as age, gender, hypertension, or biochemical parameters. Conclusion: The findings suggest that serum FGF-21 levels may be associated with coronary artery calcification and could serve as a non-invasive and easily applicable biomarker in individuals for coronary artery disease. FGF-21 may be particularly useful in clinical settings where access to advanced imaging modalities is limited.