High circulating follistatin-like protein 1 as a biomarker of a metabolically unhealthy state

Abstract

The inflammatory biomarkers that fully characterize themetabolicallyunhealthy(MU)state-which is a risk factor for cardiovascular disease (CVD)-remain unclear. Recent studies suggestfollistatin-likeprotein1(FSTL1) could be used as abiomarkerfor inflammation and CVD, however there is little information on FSTL1 levels in the MUstate. We aimed to evaluate the associations between FSTL1, the presence of MUstateand subclinical coronary atherosclerosis. In a cross-sectional study, we evaluated FSTL1 levels and their relationship with the presence of MUstateand coronary artery plaques in 230 Korean patients. Significant increase in FSTL1 levels was observed in subjects with MUstate(p = 0.020), but not those with obesitystateaccording to body mass index criteria (p = 0.790). After adjusting for confounders, the odd ratio (OR) for the MUstateamong patients in the highest FSTL1 tertile (T3) was higher in comparison with the lowest tertile (T1) (OR = 3.60, 95% confidence interval [95% CI] =1.20-10.83). In a subgroup (n = 66), FSTL1 levels were also marginally higher in patients with plaques (p = 0.098). The OR for plaque presence in patients with T3 was significantly higher in comparison with T1 after adjusting for confounders (OR = 12.51, 95% CI =1.15-135.73). Plasma FSTL1 may be a usefulbiomarkerfor the risk of MUstateand CVD.