ASPO Abstracts
Circulating Fibroblast Growth Factor-21 and Odds of Metachronous Colorectal Adenoma
Category: Early Detection & Risk Prediction
Conference Year: 2020
Abstract Body:
Purpose of the Study: Prior work has shown that higher circulating concentrations of fibroblast growth factor-21
(FGF-21), a key hormone in maintaining energy homeostasis, is associated with an increased likelihood of
developing colorectal cancer. This prospective study was conducted 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, double-blind, placebo-controlled clinical trial of the effect of 8-10 mg/kg of body weight UDCA vs.
placebo to determine if UDCA could reduce the risk of metachronous (recurrent) colorectal adenoma. Logistic
regression analyses were conducted to evaluate the association between tertile of baseline FGF-21
concentrations and odds of developing a metachronous adenoma after an average of approximately 3 years of
follow-up.
Results: Of the baseline characteristics compared across tertiles of FGF-21, 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). When baseline characteristics were compared between those
who experienced a metachronous lesion vs. those who did not, no statistically significant results were observed.
However, higher circulating concentrations of FGF-21 were statistically significantly associated with higher odds of
developing a metachronous colorectal adenoma. After adjusting for potential confounders and when compared to
the lowest tertile of FGF-21, 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 are the first to determine that, in addition to a recently-discovered association with
colorectal cancer, circulating FGF-21 concentrations are significantly and directly associated with odds of
developing early colorectal neoplasia.
Keywords: Fibroblast growth factor-21, FGF-21, colorectal adenoma, colorectal cancer