Liu Jian-Jun, Foo Joo Pin, Liu Sylvia, Lim Su Chi
Clinical Research Unit, Khoo Teck Puat Hospital, Singapore.
Department of Medicine, Changi General Hospital, Singapore.
Diabetes Res Clin Pract. 2015 Jun;108(3):382-9. doi: 10.1016/j.diabres.2015.02.032. Epub 2015 Mar 3.
Fibroblast growth factor 21 (FGF21) has been well-recognized as a metabolic hormone and a promising target for treatment of metabolic diseases. The level of endogenous FGF21 is elevated in patients with impaired glucose tolerance and progressively increased from patients with overt type 2 diabetes to those with micro- and macro-vascular complications, presumably as a compensation or response to the deterioration of metabolic imbalance. A few exploratory in vivo studies, including a recent clinical trial, showed that exogenous FGF21 mimetics targeting FGF21 signaling can attain beneficial metabolic effects not with-standing the already elevated ambient FGF21 levels. In addition, some clinically available pharmacologic agents such as fenofibrates and metformin may modulate energy and macronutrients metabolism by acting through FGF21. This review mainly focuses on the role of FGF21 in development, progression and treatment of type 2 diabetes from a clinical perspective.
成纤维细胞生长因子21（FGF21）已被公认为一种代谢激素，是治疗代谢性疾病的一个有前景的靶点。糖耐量受损患者体内内源性FGF21水平升高，且从显性2型糖尿病患者到有微血管和大血管并发症的患者，该水平逐渐增加，这可能是对代谢失衡恶化的一种补偿或反应。一些探索性的体内研究，包括最近的一项临床试验表明，靶向FGF21信号传导的外源性FGF21模拟物尽管周围FGF21水平已经升高，但仍能产生有益的代谢作用。此外，一些临床可用的药物，如非诺贝特和二甲双胍，可能通过FGF21发挥作用来调节能量和大量营养素代谢。本综述主要从临床角度关注FGF21在2型糖尿病发生、发展及治疗中的作用。
