Sex modulates the association of fibroblast growth factor 21 with end‐stage renal disease in Asian people with Type 2 diabetes: a 6.3‐year prospective cohort study
Aim To study whether plasma fibroblast growth factor 21 independently predicts the risk of end‐stage renal disease in Asian people with Type 2 diabetes. Methods In this prospective cohort study, 1700 Asian people with Type 2 diabetes were followed for a mean of 6.3 years in a regional hospital in Si...
Gespeichert in:
| Veröffentlicht in: | Diabetic medicine 2018-07, Vol.35 (7), p.880-886 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 886 |
|---|---|
| container_issue | 7 |
| container_start_page | 880 |
| container_title | Diabetic medicine |
| container_volume | 35 |
| creator | Liu, J.‐J. Liu, S. Choo, R. W. M. Wee, S. L. Xu, A. Lim, S. C. |
| description | Aim
To study whether plasma fibroblast growth factor 21 independently predicts the risk of end‐stage renal disease in Asian people with Type 2 diabetes.
Methods
In this prospective cohort study, 1700 Asian people with Type 2 diabetes were followed for a mean of 6.3 years in a regional hospital in Singapore. Incident end‐stage renal disease was identified by linkage with a national renal registry. The association of baseline fibroblast growth factor 21 levels with risk of progression to end‐stage renal disease was studied using survival analyses.
Results
Participants were aged 60 ± 10 years, with an average diabetes duration of 12 years. Their estimated GFR was 73 ± 28 ml/min/1.73 m2 and 62% had albuminuria at baseline. A total of 179 incident end‐stage renal disease cases were identified. Plasma fibroblast growth factor 21 interacted with sex in its association with end‐stage renal disease (Pinteraction = 0.003). A 1‐sd increment in fibroblast growth factor 21 (natural log‐transformed) was associated with a 1.32‐fold (95% CI 1.05–1.66, P = 0.02) increased hazard for end‐stage renal disease in women, after adjustment for traditional risk factors including estimated GFR and albuminuria. Taking death as a competing risk did not materially change the outcome [sub‐distribution hazard ratio 1.35 (95% CI 1.11–1.66, P = 0.003)]. Fibroblast growth factor 21 did not predict end‐stage renal disease risk in men after adjustment for baseline estimated GFR and albuminuria [hazard ratio 1.07 (95% CI 0.89–1.28, P = 0.49)].
Conclusions
Plasma fibroblast growth factor 21 level independently predicted risk of progression to end‐stage renal disease in women with Type 2 diabetes. The pathophysiological relationships among FGF21, sex and renal progression warrant further study.
What's new?
To our knowledge, this is the first study to show the association of fibroblast growth factor 21 (FGF21) with end‐stage renal disease (ESRD) in people with Type 2 diabetes.
Sex modulates the association of FGF21 with ESRD. This is the first study reporting sex dimorphism in the association of FGF21 with renal outcome.
Our data could prompt further studies on the role of FGF21 in the pathophysiological mechanisms of ESRD. |
| doi_str_mv | 10.1111/dme.13641 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2025319146</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2025319146</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3531-65fb9373404beb77d45d400a71b5b4684817ecf7c79217c7a69a85b49f05aeb3</originalsourceid><addsrcrecordid>eNp1kc9u1DAQhy0EokvhwAugkbjAIVs7duINt6qUP1IRB_YejZNJ11USB9thyY1H4C14L54ElxQOSPhgy_Knb2b8Y-yp4FuR1lk70FbIUol7bCNUqbJCVeI-23Ct8kxyLU7YoxBuOBd5JauH7CSvykJyyTfsxyf6CoNr5x4jBYgHAgzBNRajdSO4DjprvDM9hgjX3h3jATpsovOQCzjadKWx_fnte4h4TeBpxB5aGwgDgR3hPFgcYSI39bTi-2UiyBODhlLJV4BQbmUyLIQeJu_CRE20Xwgad3A-QohzuzxmDzrsAz25O0_Z_s3l_uJddvXx7fuL86uskYUUWVl0ppJaKq4MGa1bVbSKc9TCFEaVO7UTmppON7rKRdqxrHCXXqqOF0hGnrIXqzb18XmmEOvBhob6Hkdyc6hznqcyVfrkhD7_B71xs0_j31KFFlpwKRP1cqWaNFjw1NWTtwP6pRa8vg2vTuHVv8NL7LM742wGav-Sf9JKwNkKHG1Py_9N9esPl6vyF-ETpbY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2057171033</pqid></control><display><type>article</type><title>Sex modulates the association of fibroblast growth factor 21 with end‐stage renal disease in Asian people with Type 2 diabetes: a 6.3‐year prospective cohort study</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Liu, J.‐J. ; Liu, S. ; Choo, R. W. M. ; Wee, S. L. ; Xu, A. ; Lim, S. C.</creator><creatorcontrib>Liu, J.‐J. ; Liu, S. ; Choo, R. W. M. ; Wee, S. L. ; Xu, A. ; Lim, S. C.</creatorcontrib><description>Aim
To study whether plasma fibroblast growth factor 21 independently predicts the risk of end‐stage renal disease in Asian people with Type 2 diabetes.
Methods
In this prospective cohort study, 1700 Asian people with Type 2 diabetes were followed for a mean of 6.3 years in a regional hospital in Singapore. Incident end‐stage renal disease was identified by linkage with a national renal registry. The association of baseline fibroblast growth factor 21 levels with risk of progression to end‐stage renal disease was studied using survival analyses.
Results
Participants were aged 60 ± 10 years, with an average diabetes duration of 12 years. Their estimated GFR was 73 ± 28 ml/min/1.73 m2 and 62% had albuminuria at baseline. A total of 179 incident end‐stage renal disease cases were identified. Plasma fibroblast growth factor 21 interacted with sex in its association with end‐stage renal disease (Pinteraction = 0.003). A 1‐sd increment in fibroblast growth factor 21 (natural log‐transformed) was associated with a 1.32‐fold (95% CI 1.05–1.66, P = 0.02) increased hazard for end‐stage renal disease in women, after adjustment for traditional risk factors including estimated GFR and albuminuria. Taking death as a competing risk did not materially change the outcome [sub‐distribution hazard ratio 1.35 (95% CI 1.11–1.66, P = 0.003)]. Fibroblast growth factor 21 did not predict end‐stage renal disease risk in men after adjustment for baseline estimated GFR and albuminuria [hazard ratio 1.07 (95% CI 0.89–1.28, P = 0.49)].
Conclusions
Plasma fibroblast growth factor 21 level independently predicted risk of progression to end‐stage renal disease in women with Type 2 diabetes. The pathophysiological relationships among FGF21, sex and renal progression warrant further study.
What's new?
To our knowledge, this is the first study to show the association of fibroblast growth factor 21 (FGF21) with end‐stage renal disease (ESRD) in people with Type 2 diabetes.
Sex modulates the association of FGF21 with ESRD. This is the first study reporting sex dimorphism in the association of FGF21 with renal outcome.
Our data could prompt further studies on the role of FGF21 in the pathophysiological mechanisms of ESRD.</description><identifier>ISSN: 0742-3071</identifier><identifier>EISSN: 1464-5491</identifier><identifier>DOI: 10.1111/dme.13641</identifier><identifier>PMID: 29653030</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Aged ; Albuminuria ; Asian Continental Ancestry Group ; Cohort analysis ; Cohort Studies ; Diabetes ; Diabetes mellitus ; Diabetes mellitus (non-insulin dependent) ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - metabolism ; Diabetic Nephropathies - epidemiology ; Diabetic Nephropathies - etiology ; Diabetic Nephropathies - metabolism ; Disease Progression ; Female ; Fibroblast growth factors ; Fibroblast Growth Factors - metabolism ; Fibroblasts ; Glomerular Filtration Rate ; Growth factors ; Health risk assessment ; Humans ; Kidney diseases ; Kidney Failure, Chronic - epidemiology ; Kidney Failure, Chronic - etiology ; Kidney Failure, Chronic - metabolism ; Male ; Middle Aged ; Prognosis ; Proportional Hazards Models ; Prospective Studies ; Risk Factors ; Sex Factors ; Singapore - epidemiology</subject><ispartof>Diabetic medicine, 2018-07, Vol.35 (7), p.880-886</ispartof><rights>2018 Diabetes UK</rights><rights>2018 Diabetes UK.</rights><rights>Diabetic Medicine © 2018 Diabetes UK</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3531-65fb9373404beb77d45d400a71b5b4684817ecf7c79217c7a69a85b49f05aeb3</citedby><cites>FETCH-LOGICAL-c3531-65fb9373404beb77d45d400a71b5b4684817ecf7c79217c7a69a85b49f05aeb3</cites><orcidid>0000-0002-3361-7512</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fdme.13641$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fdme.13641$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,778,782,1414,27907,27908,45557,45558</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29653030$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Liu, J.‐J.</creatorcontrib><creatorcontrib>Liu, S.</creatorcontrib><creatorcontrib>Choo, R. W. M.</creatorcontrib><creatorcontrib>Wee, S. L.</creatorcontrib><creatorcontrib>Xu, A.</creatorcontrib><creatorcontrib>Lim, S. C.</creatorcontrib><title>Sex modulates the association of fibroblast growth factor 21 with end‐stage renal disease in Asian people with Type 2 diabetes: a 6.3‐year prospective cohort study</title><title>Diabetic medicine</title><addtitle>Diabet Med</addtitle><description>Aim
To study whether plasma fibroblast growth factor 21 independently predicts the risk of end‐stage renal disease in Asian people with Type 2 diabetes.
Methods
In this prospective cohort study, 1700 Asian people with Type 2 diabetes were followed for a mean of 6.3 years in a regional hospital in Singapore. Incident end‐stage renal disease was identified by linkage with a national renal registry. The association of baseline fibroblast growth factor 21 levels with risk of progression to end‐stage renal disease was studied using survival analyses.
Results
Participants were aged 60 ± 10 years, with an average diabetes duration of 12 years. Their estimated GFR was 73 ± 28 ml/min/1.73 m2 and 62% had albuminuria at baseline. A total of 179 incident end‐stage renal disease cases were identified. Plasma fibroblast growth factor 21 interacted with sex in its association with end‐stage renal disease (Pinteraction = 0.003). A 1‐sd increment in fibroblast growth factor 21 (natural log‐transformed) was associated with a 1.32‐fold (95% CI 1.05–1.66, P = 0.02) increased hazard for end‐stage renal disease in women, after adjustment for traditional risk factors including estimated GFR and albuminuria. Taking death as a competing risk did not materially change the outcome [sub‐distribution hazard ratio 1.35 (95% CI 1.11–1.66, P = 0.003)]. Fibroblast growth factor 21 did not predict end‐stage renal disease risk in men after adjustment for baseline estimated GFR and albuminuria [hazard ratio 1.07 (95% CI 0.89–1.28, P = 0.49)].
Conclusions
Plasma fibroblast growth factor 21 level independently predicted risk of progression to end‐stage renal disease in women with Type 2 diabetes. The pathophysiological relationships among FGF21, sex and renal progression warrant further study.
What's new?
To our knowledge, this is the first study to show the association of fibroblast growth factor 21 (FGF21) with end‐stage renal disease (ESRD) in people with Type 2 diabetes.
Sex modulates the association of FGF21 with ESRD. This is the first study reporting sex dimorphism in the association of FGF21 with renal outcome.
Our data could prompt further studies on the role of FGF21 in the pathophysiological mechanisms of ESRD.</description><subject>Aged</subject><subject>Albuminuria</subject><subject>Asian Continental Ancestry Group</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - metabolism</subject><subject>Diabetic Nephropathies - epidemiology</subject><subject>Diabetic Nephropathies - etiology</subject><subject>Diabetic Nephropathies - metabolism</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Fibroblast growth factors</subject><subject>Fibroblast Growth Factors - metabolism</subject><subject>Fibroblasts</subject><subject>Glomerular Filtration Rate</subject><subject>Growth factors</subject><subject>Health risk assessment</subject><subject>Humans</subject><subject>Kidney diseases</subject><subject>Kidney Failure, Chronic - epidemiology</subject><subject>Kidney Failure, Chronic - etiology</subject><subject>Kidney Failure, Chronic - metabolism</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Sex Factors</subject><subject>Singapore - epidemiology</subject><issn>0742-3071</issn><issn>1464-5491</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc9u1DAQhy0EokvhwAugkbjAIVs7duINt6qUP1IRB_YejZNJ11USB9thyY1H4C14L54ElxQOSPhgy_Knb2b8Y-yp4FuR1lk70FbIUol7bCNUqbJCVeI-23Ct8kxyLU7YoxBuOBd5JauH7CSvykJyyTfsxyf6CoNr5x4jBYgHAgzBNRajdSO4DjprvDM9hgjX3h3jATpsovOQCzjadKWx_fnte4h4TeBpxB5aGwgDgR3hPFgcYSI39bTi-2UiyBODhlLJV4BQbmUyLIQeJu_CRE20Xwgad3A-QohzuzxmDzrsAz25O0_Z_s3l_uJddvXx7fuL86uskYUUWVl0ppJaKq4MGa1bVbSKc9TCFEaVO7UTmppON7rKRdqxrHCXXqqOF0hGnrIXqzb18XmmEOvBhob6Hkdyc6hznqcyVfrkhD7_B71xs0_j31KFFlpwKRP1cqWaNFjw1NWTtwP6pRa8vg2vTuHVv8NL7LM742wGav-Sf9JKwNkKHG1Py_9N9esPl6vyF-ETpbY</recordid><startdate>201807</startdate><enddate>201807</enddate><creator>Liu, J.‐J.</creator><creator>Liu, S.</creator><creator>Choo, R. W. M.</creator><creator>Wee, S. L.</creator><creator>Xu, A.</creator><creator>Lim, S. C.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3361-7512</orcidid></search><sort><creationdate>201807</creationdate><title>Sex modulates the association of fibroblast growth factor 21 with end‐stage renal disease in Asian people with Type 2 diabetes: a 6.3‐year prospective cohort study</title><author>Liu, J.‐J. ; Liu, S. ; Choo, R. W. M. ; Wee, S. L. ; Xu, A. ; Lim, S. C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3531-65fb9373404beb77d45d400a71b5b4684817ecf7c79217c7a69a85b49f05aeb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aged</topic><topic>Albuminuria</topic><topic>Asian Continental Ancestry Group</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes mellitus (non-insulin dependent)</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - metabolism</topic><topic>Diabetic Nephropathies - epidemiology</topic><topic>Diabetic Nephropathies - etiology</topic><topic>Diabetic Nephropathies - metabolism</topic><topic>Disease Progression</topic><topic>Female</topic><topic>Fibroblast growth factors</topic><topic>Fibroblast Growth Factors - metabolism</topic><topic>Fibroblasts</topic><topic>Glomerular Filtration Rate</topic><topic>Growth factors</topic><topic>Health risk assessment</topic><topic>Humans</topic><topic>Kidney diseases</topic><topic>Kidney Failure, Chronic - epidemiology</topic><topic>Kidney Failure, Chronic - etiology</topic><topic>Kidney Failure, Chronic - metabolism</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Sex Factors</topic><topic>Singapore - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Liu, J.‐J.</creatorcontrib><creatorcontrib>Liu, S.</creatorcontrib><creatorcontrib>Choo, R. W. M.</creatorcontrib><creatorcontrib>Wee, S. L.</creatorcontrib><creatorcontrib>Xu, A.</creatorcontrib><creatorcontrib>Lim, S. C.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetic medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Liu, J.‐J.</au><au>Liu, S.</au><au>Choo, R. W. M.</au><au>Wee, S. L.</au><au>Xu, A.</au><au>Lim, S. C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sex modulates the association of fibroblast growth factor 21 with end‐stage renal disease in Asian people with Type 2 diabetes: a 6.3‐year prospective cohort study</atitle><jtitle>Diabetic medicine</jtitle><addtitle>Diabet Med</addtitle><date>2018-07</date><risdate>2018</risdate><volume>35</volume><issue>7</issue><spage>880</spage><epage>886</epage><pages>880-886</pages><issn>0742-3071</issn><eissn>1464-5491</eissn><abstract>Aim
To study whether plasma fibroblast growth factor 21 independently predicts the risk of end‐stage renal disease in Asian people with Type 2 diabetes.
Methods
In this prospective cohort study, 1700 Asian people with Type 2 diabetes were followed for a mean of 6.3 years in a regional hospital in Singapore. Incident end‐stage renal disease was identified by linkage with a national renal registry. The association of baseline fibroblast growth factor 21 levels with risk of progression to end‐stage renal disease was studied using survival analyses.
Results
Participants were aged 60 ± 10 years, with an average diabetes duration of 12 years. Their estimated GFR was 73 ± 28 ml/min/1.73 m2 and 62% had albuminuria at baseline. A total of 179 incident end‐stage renal disease cases were identified. Plasma fibroblast growth factor 21 interacted with sex in its association with end‐stage renal disease (Pinteraction = 0.003). A 1‐sd increment in fibroblast growth factor 21 (natural log‐transformed) was associated with a 1.32‐fold (95% CI 1.05–1.66, P = 0.02) increased hazard for end‐stage renal disease in women, after adjustment for traditional risk factors including estimated GFR and albuminuria. Taking death as a competing risk did not materially change the outcome [sub‐distribution hazard ratio 1.35 (95% CI 1.11–1.66, P = 0.003)]. Fibroblast growth factor 21 did not predict end‐stage renal disease risk in men after adjustment for baseline estimated GFR and albuminuria [hazard ratio 1.07 (95% CI 0.89–1.28, P = 0.49)].
Conclusions
Plasma fibroblast growth factor 21 level independently predicted risk of progression to end‐stage renal disease in women with Type 2 diabetes. The pathophysiological relationships among FGF21, sex and renal progression warrant further study.
What's new?
To our knowledge, this is the first study to show the association of fibroblast growth factor 21 (FGF21) with end‐stage renal disease (ESRD) in people with Type 2 diabetes.
Sex modulates the association of FGF21 with ESRD. This is the first study reporting sex dimorphism in the association of FGF21 with renal outcome.
Our data could prompt further studies on the role of FGF21 in the pathophysiological mechanisms of ESRD.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>29653030</pmid><doi>10.1111/dme.13641</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-3361-7512</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0742-3071 |
| ispartof | Diabetic medicine, 2018-07, Vol.35 (7), p.880-886 |
| issn | 0742-3071 1464-5491 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2025319146 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Aged Albuminuria Asian Continental Ancestry Group Cohort analysis Cohort Studies Diabetes Diabetes mellitus Diabetes mellitus (non-insulin dependent) Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - metabolism Diabetic Nephropathies - epidemiology Diabetic Nephropathies - etiology Diabetic Nephropathies - metabolism Disease Progression Female Fibroblast growth factors Fibroblast Growth Factors - metabolism Fibroblasts Glomerular Filtration Rate Growth factors Health risk assessment Humans Kidney diseases Kidney Failure, Chronic - epidemiology Kidney Failure, Chronic - etiology Kidney Failure, Chronic - metabolism Male Middle Aged Prognosis Proportional Hazards Models Prospective Studies Risk Factors Sex Factors Singapore - epidemiology |
| title | Sex modulates the association of fibroblast growth factor 21 with end‐stage renal disease in Asian people with Type 2 diabetes: a 6.3‐year prospective cohort study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-16T21%3A10%3A21IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Sex%20modulates%20the%20association%20of%20fibroblast%20growth%20factor%2021%20with%20end%E2%80%90stage%20renal%20disease%20in%20Asian%20people%20with%20Type%202%20diabetes:%20a%206.3%E2%80%90year%20prospective%20cohort%20study&rft.jtitle=Diabetic%20medicine&rft.au=Liu,%20J.%E2%80%90J.&rft.date=2018-07&rft.volume=35&rft.issue=7&rft.spage=880&rft.epage=886&rft.pages=880-886&rft.issn=0742-3071&rft.eissn=1464-5491&rft_id=info:doi/10.1111/dme.13641&rft_dat=%3Cproquest_cross%3E2025319146%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2057171033&rft_id=info:pmid/29653030&rfr_iscdi=true |