Biological Role, Clinical Significance and Therapeutic Possibilities of the Recently Discovered Metabolic Hormone Fibroblastic Growth Factor 21.

European Journal of Endocrinology, 2012

Abstract Fibroblast growth factor 21 (FGF-21), a 181-amino acid circulating protein with relevant metabolic actions.
Beta-cell function and survival are preserved and glucagon secretion is reduced by this protein, thus decreasing hepatic glucose production and improving insulin sensitivity.
FGF-21 increases energy expenditure in rodents and induces weight loss in diabetic nonhuman primates.
Adaptative metabolic responses to fasting, including stimulation of ketogenesis and fatty acid oxidation, seem to be partially mediated by FGF-21.
In humans, serum FGF-21 concentrations have been found elevated in insulin-resistant states, such as impaired glucose tolerance and type 2 diabetes.
FGF-21 levels are correlated with hepatic insulin resistance index, fasting blood glucose, hemoglobin A1c, and blood glucose after an oral glucose tolerance test.
A relationship between FGF-21 levels and long-term diabetic complication, such as nephropathy and carotid atheromatosis has been reported.
Weight loss is accompanied by a decrease in FGF-21 levels in humans, suggesting a relationship of this hormone with the improvement in insulin sensitivity associated to weight loss.
In patients with renal disease FGF-21 levels exhibited a progressive increase as renal function deteriorates.
Circulating FGF-21 levels seem to be related with insulin resistance and inflammation in dialysis patients.