Abstract
Background Fibroblast growth factor 21 (FGF21) acts as a potent metabolic regulator. Serum FGF21 levels were significantly higher in obesity and type 2 diabetes mellitus (T2DM) populations. The aim of this study was to evaluate the relationship between serum FGF21 levels and metabolic syndrome (MetS) in T2DM patients. Methods Fasting blood samples were obtained from 126 T2DM patients. MetS and its components were defined according to the diagnostic criteria from the International Diabetes Federation. Serum FGF21 concentrations were measured using a commercially available enzyme-linked immunosorbent assay. Results Among these patients, 84 (66.7%) had MetS. Female gender, hypertension, systolic blood pressure (SBP), diastolic blood pressure (DBP), waist circumference (WC), body weight (BW), body mass index (BMI), body fat mass, fasting glucose, glycated hemoglobin level (HbA1c), triglyceride level (TG), urine albumin-to-creatinine ratio (UACR), insulin level, homeostasis model assessment of insulin resistance (HOMA-IR), and FGF21 levels were higher, whereas high-density lipoprotein cholesterol level (HDL-C) and estimated glomerular filtration rate (eGFR) were lower in DM patients with MetS. Univariate linear analysis revealed that hypertension, BMI, WC, body fat mass, SBP, DBP, logarithmically transformed TG (log-TG), low-density lipoprotein cholesterol (LDL-C) level, log-glucose, log-creatinine, log-UACR, log-insulin, and log-HOMA-IR positively correlated, whereas HDL-C and eGFR negatively correlated with serum FGF21 levels in T2DM patients. Multivariate forward stepwise linear regression analysis revealed that body fat mass (adjusted R2 change = 0.218; P=0.008) and log-TG (adjusted R2 change = 0.036; P < 0.001) positively correlated, whereas eGFR (adjusted R2 change = 0.033; P=0.013) negatively correlated with serum FGF21 levels in T2DM patients. Conclusions This study showed that higher serum FGF21 levels were positively associated with MetS in T2DM patients and significantly positively related to body fat mass and TG but negatively related to eGFR in these subjects.
Highlights
Type 2 diabetes mellitus (T2DM), a chronic metabolic disease characterized by hyperglycemia and insulin resistance, is a significant health problem and global burden, with an increasing prevalence worldwide [1]
Multivariate forward stepwise linear regression analysis of the variables significantly associated with fasting serum Fibroblast growth factor 21 (FGF21) levels revealed that body fat mass and log-triglyceride level (TG) positively correlated, whereas estimated glomerular filtration rate (eGFR) negatively correlated with serum FGF21 levels in patients with type 2 diabetes mellitus (T2DM)
Our study reveals that T2DM patients with metabolic syndrome (MetS) have significantly higher body weight (BW), body mass index (BMI), waist circumference (WC), body fat mass, and systolic blood pressure (SBP) and diastolic blood pressure (DBP) values; higher prevalence of hypertension; elevated TG, fasting glucose, and HbA1c concentrations; and lower high-density lipoprotein cholesterol level (HDL-C) level than T2DM patients without MetS
Summary
Type 2 diabetes mellitus (T2DM), a chronic metabolic disease characterized by hyperglycemia and insulin resistance, is a significant health problem and global burden, with an increasing prevalence worldwide [1]. Fibroblast growth factor 21 (FGF21) is a polypeptide with 210 amino acids from a human gene located on chromosome 19 at the 5′ region of the 1,2-fucosyltransferase. Epidemiology studies revealed that higher serum FGF21 is an independent predictor of the MetS in Asian individuals and FGF21 levels elevated significantly among prediabetic and diabetic patients and can predict the diabetes development in a Chinese population [9, 10]. Emerging studies have evaluated the relationships of this hepatokine to obesity-related disease, whether or not FGF21 predicts MetS in T2DM patients, the interrelationships of FGF21 with the metabolic parameters among these populations have not been described in detail. Erefore, we investigated how circulating FGF21 levels are correlated with metabolic parameters in T2DM Taiwanese patients with MetS
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