Division of Endocrinology, Ege University Faculty of Medicine, Ankara Street, Bornova, Izmir, Turkey.
Department of Biochemistry, Izmir Bozyaka Education and Research Hospital, Izmir, Turkey.
J Endocrinol Invest. 2019 Jan;42(1):53-60. doi: 10.1007/s40618-018-0885-1. Epub 2018 May 12.
Fibroblast growth factor-21 (FGF-21) is a member of fibroblast growth factor family. Both growth hormone (GH) and FGF-21 take place in the regulation of glucose and lipid metabolism. We aimed to investigate FGF-21 levels in acromegaly which is characterized by excess GH levels and is associated with comorbidities and altered body composition.
We studied 43 subjects (21 females and 22 males, mean age of 50.0 ± 12.8) with acromegaly. The control group consisted of 40 gender- and age-matched subjects (25 females and 15 males, mean age of 48.8 ± 8.8). Acromegaly patients were classified into two groups; active acromegaly (AA; n = 26) and controlled acromegaly (CA; n = 17). Metabolic, anthropometric and laboratory values of subjects were recorded. FGF-21 level was measured by ELISA assay.
Median FGF-21 levels were significantly higher in acromegaly group compared to control group (85.5 vs. 59.0 pg/mL, p = 0.02, respectively). In the multiple regression model, FPG, A1c, HOMA-IR, glucose intolerance, BMI, visceral fat, hs-CRP, presence of hypertension, dyslipidemia and acromegaly were included as independent variables to explain variability of plasma FGF-21 levels in whole study group. The presence of acromegaly was the only determinant of increased FGF-21 levels in the whole study group (β coefficient = 0.253, p = 0.006).
FGF-21 levels were increased significantly in acromegaly group. Increased FGF-21 levels were significantly and independently associated with the state of acromegaly. Acromegaly may also be a FGF-21 resistance state independent from insulin resistance, glucose intolerance, obesity, hypertension and dyslipidemia.
成纤维细胞生长因子 21（FGF-21）是成纤维细胞生长因子家族的一员。生长激素（GH）和 FGF-21 都参与了葡萄糖和脂质代谢的调节。我们旨在研究肢端肥大症患者的 FGF-21 水平，肢端肥大症的特点是 GH 水平过高，与合并症和身体成分改变有关。
我们研究了 43 名肢端肥大症患者（21 名女性和 22 名男性，平均年龄 50.0±12.8）。对照组由 40 名性别和年龄匹配的受试者组成（25 名女性和 15 名男性，平均年龄 48.8±8.8）。肢端肥大症患者分为两组：活动肢端肥大症（AA；n=26）和控制肢端肥大症（CA；n=17）。记录受试者的代谢、人体测量和实验室值。FGF-21 水平通过 ELISA 测定。
肢端肥大症组的 FGF-21 水平明显高于对照组（85.5 vs. 59.0 pg/mL，p=0.02）。在多元回归模型中，将 FPG、A1c、HOMA-IR、葡萄糖耐量异常、BMI、内脏脂肪、hs-CRP、高血压、血脂异常和肢端肥大症作为独立变量，解释整个研究组血浆 FGF-21 水平的变异性。在整个研究组中，肢端肥大症的存在是 FGF-21 水平升高的唯一决定因素（β系数=0.253，p=0.006）。
肢端肥大症组的 FGF-21 水平显著升高。升高的 FGF-21 水平与肢端肥大症的状态显著且独立相关。肢端肥大症可能也是一种与胰岛素抵抗、葡萄糖耐量异常、肥胖、高血压和血脂异常无关的 FGF-21 抵抗状态。
