A Comprehensive Review on the Metabolic Cooperation Role of Nuclear Factor E2-Related Factor 2 and Fibroblast Growth Factor 21 against Homeostasis Changes in Diabetes

Abstract

Objective: Type 1 and type 2 diabetes are associated with metabolic disorders including hyperglycemia, hyperlipidemia, and inflammation, leading to the production of reactive oxygen species and nitrogen activators. In these cases, some of the body’s innate factors are activated to cope with these dangerous situations. The purpose of the review is to explain the collaboration between the nuclear factor E2-related factor 2 (NRF2) and fibroblast growth factor 21 (FGF21) in homeostasis and body metabolism with a focus on diabetes. Materials and methods: This review is based on searching the PubMed database, SCOPUS, Elsevier and citation lists of relevant publications. Subject heading and key words used include diabetes, oxidative stress, inflammation, NRF2, and FGF21. Only articles in English were included. Results: NRF2 and FGF21 are two attractive biomarkers for the diagnosis of specific metabolic disorders and therapeutic targets, which have been implicated as therapeutic targets for the management of diabetic complications. The combination of both factors leads to the regulation of antioxidant and anti-inflammatory responses and metabolic pathways. Conclusions: Given most studies of NRF2- and FGF21-based therapeutic interventions in animal models and the possibility of not achieving the same results in humans, further clinical studies are needed to determine the efficacy of NRF2 and FGF21 in treatment of patients with diabetes.