Gao Ruo-Yao, Hsu Bang-Gee, Wu Du-An, Hou Jia-Sian, Chen Ming-Chun
School of Medicine, Tzu Chi University, Hualien, Taiwan.
Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
Int J Endocrinol. 2019 Sep 10;2019:5163245. doi: 10.1155/2019/5163245. eCollection 2019.
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.
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.
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 change = 0.218; =0.008) and log-TG (adjusted change = 0.036; < 0.001) positively correlated, whereas eGFR (adjusted change = 0.033; =0.013) negatively correlated with serum FGF21 levels in T2DM patients.
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.
成纤维细胞生长因子21（FGF21）是一种有效的代谢调节因子。肥胖和2型糖尿病（T2DM）人群的血清FGF21水平显著升高。本研究旨在评估T2DM患者血清FGF21水平与代谢综合征（MetS）之间的关系。
从126例T2DM患者中采集空腹血样。根据国际糖尿病联盟的诊断标准定义MetS及其组分。使用市售的酶联免疫吸附测定法测量血清FGF21浓度。
在这些患者中，84例（66.7%）患有MetS。患有MetS的T2DM患者的女性性别、高血压、收缩压（SBP）、舒张压（DBP）、腰围（WC）、体重（BW）、体重指数（BMI）、体脂肪量、空腹血糖、糖化血红蛋白水平（HbA1c）、甘油三酯水平（TG）、尿白蛋白与肌酐比值（UACR）、胰岛素水平、胰岛素抵抗稳态模型评估（HOMA-IR）和FGF21水平较高，而高密度脂蛋白胆固醇水平（HDL-C）和估算肾小球滤过率（eGFR）较低。单因素线性分析显示，高血压、BMI、WC、体脂肪量、SBP、DBP、对数转换后的TG（log-TG）、低密度脂蛋白胆固醇（LDL-C）水平、log-葡萄糖、log-肌酐、log-UACR、log-胰岛素和log-HOMA-IR呈正相关，而HDL-C和eGFR与T2DM患者的血清FGF21水平呈负相关。多因素向前逐步线性回归分析显示，体脂肪量（调整变化=0.218；P=0.008）和log-TG（调整变化=0.036；P<0.001）与T2DM患者的血清FGF21水平呈正相关，而eGFR（调整变化=0.033；P=0.013）与T2DM患者的血清FGF21水平呈负相关。
本研究表明，T2DM患者中较高的血清FGF21水平与MetS呈正相关，且与体脂肪量和TG显著正相关，但与这些受试者的eGFR负相关。
