Change And Clinical Significance Of Serum Fibroblast Growth Factor 21 Levels In Type 2 Diabetic Patients

Objective: To investigate serum fibroblast growth factor 21 (FGF-21) levels in type 2 diabetic patients, and to explore the correlation between its serum levels and anthropometric parameters, glucose-lipid metabolism parameters, insulin sensitivity index, inflammatory factors etc.Methods: Fifty-four newly diagnosed patients with type 2 diabetes mellitus (NDDM), 54 subjects with the duration of diabetes more than five years (LDDM), and 35 normal controls participated in the study. Fasting serum FGF-21 levels were measured with an enzyme-linked immunosorbent assay. The anthropometric parameters, glucose, lipids, insulin and high sensitive c-reactive protein (hsCRP) levels were also measured in fasting status and Waist-to-hip ratio (WHR), Body mass index (BMI), HOMA index-insulin resistance (HOMA-IR) and HOMA index-βcell insulin secretion (HOMA-β) were calculated.Results: Serum FGF-21 levels were significantly higher in NDDM and LDDM groups than in controls (361.80±140.28 pg/ml and 351.17±133.44 pg/ml vs. 185.89±59.29 pg/ml, both P<0.01), but there was no difference in serum FGF-21 levels between NDDM and LDDM. Fasting serum FGF-21 was found to correlate positively and significantly with age, WHR, systolic blood pressure (SBP), fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), HOMA-IR and hsCRP, but negatively with HOMA-β.Furthermore, multiple regression analysis showed that fasting insulin (FINS), HOMA-IR, low-density lipoprotein cholesterol (LDL-C) and hsCRP were independent factors influencing serum FGF-21 levels. Logistic regression analysis demonstrated that serum FGF-21 was significantly associated with T2DM. Conclusion: Serum FGF-21 levels are significantly increased in patients with T2DM.. They may be influenced by adiposity, glucose-lipid metabolism, insulin secretion or action and inflammatory factors. Importantly, FGF-21 may play a role in the pathogenesis of T2DM.