Preliminary FGF21 Serum Levels In Children With Metabolic Syndrome In The Relationship

Objective:Recently, a novel protein, fibroblast growth factor21(FGF21) has gained a lot of attention due to its beneficial effects on glucose homeostasis and lipid metabolism in animal models. However, the physiological and pathologic roles of FGF21in human remain unclear. This study aimed to investigate the relationship between its serum levels and metabolic syndrome (MS) in children.Methods:820Chinese subjects aged6to18years were recruited from the Beijing Child and Adolescent Metabolic Syndrome study. Anthropometric parameters, fasting lipid profile, glucose, fasting insulin, leptin, adiponectin, resistin and FGF21were measured. MS was diagnosed according to the modified Adult Treatment Panel Ⅲ (ATPⅢ) criteria.Results:There was no sex difference in serum FGF21levels (P=0.082). A slightly increase in FGF21levels during middle puberty was observed in both genders.Though medians of FGF21levels in each group increased progressively from normal weight to overweight to obese, they did not reach statistical significant. FGF21levels in children with and without MS did not show significant difference either.In the whole cohort, univariate association analysis between FGF21and waist circumference, body mass index (BMI), fat mass percentage, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose, insulin and fasting lipid profile showed that FGF21only had correlation with DBP (r=0.08, P=0.023), leptin (r=0.085, P=0.015) and resistin (r=0.078, P=0.027). Adjusted for age, gender and BMI, fasting blood glucose also correlated with FGF21(r=0.074, P=0.038)The whole population was then divided into quartiles based on FGF21levels. The percentages of obese children in each group were almost the same. A J-shaped association of the incidences of MS and MS components with FGF21was observed. Both the first and the fouth quartiles were associated with higher incidences of carrying1or more MS components (P=0.016). MS incidences in groups of obese children divided according to the above quartiles also showed significant difference (P=0.044). A J-shaped association of hypoadiponectinemia with FGF21was also observed, but only in girls. In the whole population, logistic regression analysis showed that both high (OR=1.681,P=0.041) and low(OR=1.924,P=0.009) levels of FGF21were associated with increased risk of carrying metabolic components in children, while in the obese subgroup, high level of FGF21was associated with increased risk of developing MS (OR=19.971, P=0.013),even after ajusting for age, gender and BMI.Conclusion:In this study, serum FGF21level did not correlate with obesity. A J-shaped association between FGF21levels and incidences of MS and MS components in children was observed, showing that not only higher level but also lower level of FGF21indicated adverse metabolic profiles.