Effects of an interdisciplinary weight loss program on fibroblast growth factor 21 and inflammatory biomarkers in women with overweight and obesity

Abstract

Objective: To investigate the effects of an interdisciplinary intervention on biomarkers of inflammation and their relationship with fibroblast growth factor 21 (FGF21) concentrations in women with overweight and obesity. Subjects and methods: Thirty-one women were enrolled in a 12-week interdisciplinary weight loss program delivered by a team comprising an endocrinologist, nutritionist and exercise physiologist. Body composition; anthropometric measures; metabolic and inflammatory markers including adiponectin, leptin, and atrial natriuretic peptide (ANP) were assessed at baseline and post-therapy. The homeostasis model assessment of insulin resistance (HOMA-IR) and the homeostasis model assessment of adiponectin (HOMA-AD) were calculated. The participants were divided into two groups: those with increased FGF21, and those with decreased FGF21. Results: The sample comprised women aged 32 ± 5 years with a body mass index of 33.64 ± 3.49 kg/m². Body weight, waist circumference and leptin concentration were decreased in the whole sample after therapy. However, only the group with an increase in FGF21 concentration presented significant improvements in adiponectin concentration and adiponectin/leptin ratio. Moreover, although there was a reduction of leptin in both groups, it was greater in the increased FGF21 groups. There was a reduction in ANP in the decreased FGF21 group. Conclusions: Changes in FGF21 concentrations were different among the women participating in the weight loss program, with some having increased levels and some reduced levels. Furthermore, improvements in adiponectin and the adiponectin/ leptin ratio were found only in the group with increased FGF21 concentration.

Exercise-Induced Fibroblast Growth Factor-21: A Systematic Review and Meta-Analysis

“…Of the 72 studies, 24 were excluded after title and abstract review, and the original text of 48 studies was reviewed. After screening the studies according to the inclusion criteria, 38 studies were excluded, and finally, 10 studies were selected ( Figure 1 ) [ 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ].…”

“…The quality of four studies [ 29 , 30 , 33 , 35 ] was assessed using the RoB tool, and the results were as follows: random sequence generation (low, 1; uncertain, 2; high, 1), allocation concealment (low, 1; uncertain, 3), blinding of participants and personnel (low, 1; uncertain, 3), blinding outcome assessment (low, 1; uncertain, 3), incomplete outcome data (low, 3; high, 1), selective reporting (low, 4), and other biases (low, 1; uncertain, 2; high, 1) ( Figure 2 ). Four studies [ 26 , 27 , 28 , 31 , 32 , 34 ] were assessed by the RoBANS, and the results were as follows: selection of participants (low, 4; uncertain, 1; high, 1), confounding variables (low, 1; uncertain, 4; high, 1), measurement of exposure (low, 5; uncertain, 1), blinding of outcome assessments (low, 4; uncertain, 2), incomplete outcome data (low, 5; uncertain, 1), and selective outcome reporting (low, 5; uncertain, 1) ( Table 1 ).…”

“… Forest plot of within-group comparisons of exercise-induced changes in fibroblast growth factor-21 levels [ 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ]. Keihanian et al, 2019(a) [ 29 ]—resistance exercise; Keihanian et al, 2019(b) [ 29 ]—aerobic exercise; Shabkhiz et al, 2021(a) [ 30 ]—participants without type 2 diabetes; Shabkhiz et al, 2021(b) [ 30 ]—participants with type 2 diabetes.…”

Targeting FGF21 in cardiovascular and metabolic diseases: from mechanism to medicine

“…Consistently, one study that enrolled overweight and obese women found that changes in FGF21 levels differed among the subjects participating in the interdisciplinary intervention. Furthermore, they found that the adiponectin/leptin ratio was changed only in people with elevated FGF21 [149]. The changes in FGF21 levels after dietary interventions in different people can be used to assess the individual predisposition to weight gain over time.…”

Effects of interdisciplinary therapy on reducing ultra-processed food consumption and its impact on cardiometabolic risks factor in women with obesity

“…Using a blended intervention model, body weight was monitored weekly by self-report. The program is described in detail in a previous publication (27).…”