Serum fibroblast growth factor 21 levels in polycystic ovary syndrome

Gorar, Suheyla; Culha, Cavit; Üç, Zi̇ynet Alphan; Dellal, Fatma Dilek; Serter, Rüştü; Aral, Sema; Aral, Yalcin

doi:10.3109/09513590.2010.487587

Cited by 38 publications

(27 citation statements)

References 32 publications

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“…FGF21 was also an independent predictor of DM2 in humans and its elevation is independent of the DM2 duration (62). Lastly, FGF21 seems to be also independently associated with markers of insulin resistance and an adverse lipid profile in polycystic ovary syndrome (63) and gestational diabetes (64).…”

Section: Fgf21 Insulin Resistance and Type 2 Diabetesmentioning

confidence: 84%

MECHANISMS IN ENDOCRINOLOGY: Biological role, clinical significance, and therapeutic possibilities of the recently discovered metabolic hormone fibroblastic growth factor 21

Iglesias

Selgas

Romero

et al. 2012

European Journal of Endocrinology

101

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Fibroblast growth factor 21 (FGF21), a 181 amino acid circulating protein, is a member of the FGF superfamily, with relevant metabolic actions. It acts through the interaction with specific FGF receptors and a cofactor called β-Klotho, whose expression is predominantly detected in metabolically active organs. FGF21 stimulates glucose uptake in adipocytes via the induction of glucose transporter-1. This action is additive and independent of insulin. β-Cell function and survival are preserved, and glucagon secretion is reduced by this protein, thus decreasing hepatic glucose production and improving insulin sensitivity. Lipid profile has been shown to be improved by FGF21 in several animal models. FGF21 increases energy expenditure in rodents and induces weight loss in diabetic nonhuman primates. It also exerts favorable effects on hepatic steatosis and reduces tissue lipid content in rodents. Adaptive metabolic responses to fasting, including stimulation of ketogenesis and fatty acid oxidation, seem to be partially mediated by FGF21. In humans, serum FGF21 concentrations have been found elevated in insulin-resistant states, such as impaired glucose tolerance and type 2 diabetes. FGF21 levels are correlated with hepatic insulin resistance index, fasting blood glucose, HbA1c, and blood glucose after an oral glucose tolerance test. A relationship between FGF21 levels and long-term diabetic complications, such as nephropathy and carotid atheromatosis, has been reported. FGF21 levels decreased in diabetic patients after starting therapy with insulin or oral agents. Increased FGF21 serum levels have also been found to be associated with obesity. In children, it is correlated with BMI and leptin levels, whereas in adults, FGF21 levels are mainly related to several components of the metabolic syndrome. Serum FGF21 levels have been found to be elevated in patients with ischemic heart disease. In patients with renal disease, FGF21 levels exhibited a progressive increase as renal function deteriorates. Circulating FGF21 levels seem to be related to insulin resistance and inflammation in dialysis patients. In summary, FGF21 is a recently identified hormone with antihyperglycemic, antihyperlipidemic, and thermogenic properties. Direct or indirect potentiation of its effects might be a potential therapeutic target in insulin-resistant states.

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Section: Fgf21 Insulin Resistance and Type 2 Diabetesmentioning

confidence: 84%

MECHANISMS IN ENDOCRINOLOGY: Biological role, clinical significance, and therapeutic possibilities of the recently discovered metabolic hormone fibroblastic growth factor 21

Iglesias

Selgas

Romero

et al. 2012

European Journal of Endocrinology

101

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“…Gorar et al (33) showed positive correlations between FGF21 levels and serum LH and testosterone concentrations, while Sahin et al (34) observed a negative correlation between FGF21 and DHEA-S levels. We did not observe any associations between FGF21 and gonadotropins as well as androgens, while a weak, negative correlation between FGF21 and E 2 levels was found.…”

Section: Discussionmentioning

confidence: 98%

Circulating FGF21 levels are related to nutritional status and metabolic but not hormonal disturbances in polycystic ovary syndrome

Olszanecka-Glinianowicz¹,

Madej²,

Wdowczyk³

et al. 2015

European Journal of Endocrinology

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Objective: The aim of this study was to analyse relationships between plasma fibroblast growth factor 21 (FGF21) levels and nutritional status, and metabolic and hormonal disturbances in polycystic ovary syndrome (PCOS) women. Design and setting: A cross-sectional study involving 85 PCOS (48 obese) and 72 non-PCOS women (41 obese) was conducted to evaluate the relationship between FGF21 levels and PCOS. Methods: Anthropometric parameters and body composition were determined. In the fasting state; serum concentrations of glucose, androgens, FSH, LH, SHBG, insulin and FGF21 were measured. Results: Plasma FGF21 levels were significantly higher in obese women compared with normal-weight women in both PCOS and non-PCOS subgroups (120.3 (18.2-698) vs 62.3 (16.4-323.6) pg/ml, P!0.05 and 87.2 (12.9-748.4) vs 62.9 (18.0-378.8) pg/ml, P!0.05 respectively). Additionally, circulating FGF21 levels were significantly higher in the obese PCOS subgroup compared with the non-PCOS subgroup (120.3 (18.2-698.0) vs 87.2 (12.9-748.4) pg/ml, P!0.05). Circulating FGF21 levels were proportional to BMI (RZ0.27; P!0.001), body fat mass (RZ0.24; P!0.01) and percentage (RZ0.24; P!0.01), as well as waist circumference (RZ0.26; P!0.01). Additionally, plasma insulin and homeostasis model assessment of insulin resistance (HOMA-IR) values were related to FGF21 levels (RZ0.44; P!0.001 and RZ0.19; P!0.05 respectively). In multiple regression analysis, circulating FGF21 level variability was explained by HOMA-IR values and fat percentage, as well as waist circumference, but not correlated with oestradiol levels and free androgen index values. Conclusions: Higher circulating FGF21 levels are related to nutritional status and insulin resistance independent of PCOS. Increased FGF21 is associated with metabolic but not hormonal disturbances.

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“…In our data, it was found that FGF21 was negatively correlated with E2 in diabetic women. In polycystic ovary syndrome and healthy subjects, a positive correlation was also found between FGF21 and LH and T (r = 0.43 p = 0.007; r = 0.38, P = 0.02, respectively) [31]. Another study found there was a significantly negative correlation between FGF21 and dehydroepiandrosterone sulfte (DHEAS) (r = −0.309 p = 0.003) [32].…”

Section: Discussionmentioning

confidence: 99%

Serum fibroblast growth factor 21 levels is associated with lower extremity atherosclerotic disease in Chinese female diabetic patients

Zhang

Zeng

et al. 2015

Cardiovasc Diabetol

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BackgroundFibroblast growth factor 21 (FGF21) is an emerging metabolic regulator associated with glucose and lipid metabolism, and it is still unclear whether FGF21 is related to atherosclerosis. Here, we explored the potential link between FGF21 and lower extremity atherosclerotic disease (LEAD) in type 2 diabetic patients.MethodsA cross-sectional study was conducted on 504 type 2 diabetic patients (283 men, 221 women). LEAD was defined by Ankle-brachial index (ABI) <0.9 and lower extremity arterial plaque evaluated by color Doppler ultrasound. Serum FGF21 concentrations were quantified by a sandwich enzyme-linked immunosorbent assay.ResultsThe total FGF21 levels of male and female patients had no significant differenence ((299.14(177.31-534.49) vs 362.50(214.01-578.73), P=0.516). Serum FGF21 levels in LEAD group were significantly higher than non-LEAD group in females (385.34(243.89-661.54) vs 313.13(156.38-485.79), P=0.006), while not in male patients (295.52(177.09-549.64) vs 342.09 (198.70-549.87), P=0.613). In diabetic women, subjects with LEAD had significantly higher serum FGF21 regardless of non-alcoholic fatty liver disease (NAFLD) (P < 0.05). And serum FGF21 levels were positively correlated with waist circumference and systolic blood pressure after adjusted for age and BMI (r=0.198, P=0.004; r=0.152, P=0.027; respectively). Moreover, FGF21 was independently tied to femoral intima-media thickness (FIMT) (β=0.208, P=0.031). After adjusted for other LEAD risk factors, FGF21 was demonstrated to be an independent risk factor for LEAD in type 2 diabetic women (OR, 1.106; 95%CI 1.008-1.223; P=0.028). In addition, FGF21 was negatively correlated with estradiol in premenopausal diabetic women (r=−0.368, P=0.009). After adjusted for estradiol, serum FGF21 levels were still positively associated with FIMT in premenopausal diabetic women (r=0.381, P=0.007). In diabetic men, serum FGF21 levels were correlated with triglyceride and C-reactive protein even after adjusted for age and BMI (r=0.204, P=0.001; r=0.312, P < 0.001; respectively). However, serum FGF21 was not an independent impact factor for LEAD in men (P > 0.05).ConclusionsSerum FGF21 level independently and positively links LEAD in Chinese women with type 2 diabetes. The gender difference may be due to different estrogen levels.

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Serum fibroblast growth factor 21 levels in polycystic ovary syndrome

Abstract: Our study indicates that FGF21 in cases with PCOS exhibit an increase along with the increase of BMI and also has a positive correlation with LH and T. Further studies are required to clarify the aetiology and effects of FGF21 in women with PCOS.

Cited by 38 publications

References 32 publications

MECHANISMS IN ENDOCRINOLOGY: Biological role, clinical significance, and therapeutic possibilities of the recently discovered metabolic hormone fibroblastic growth factor 21

MECHANISMS IN ENDOCRINOLOGY: Biological role, clinical significance, and therapeutic possibilities of the recently discovered metabolic hormone fibroblastic growth factor 21

Circulating FGF21 levels are related to nutritional status and metabolic but not hormonal disturbances in polycystic ovary syndrome

Serum fibroblast growth factor 21 levels is associated with lower extremity atherosclerotic disease in Chinese female diabetic patients

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