Distinct changes in serum fibroblast growth factor 21 levels in different subtypes of diabetes.
OBJECTIVE
Fibroblast growth factor (FGF) 21 is an endocrine factor with multiple beneficial effects on glucose and lipid metabolism in animals. This study aimed to investigate the association of serum FGF21 levels with type 1 diabetes, latent autoimmune diabetes in adults (LADA) and type 2 diabetes.


METHODS
Serum FGF21 levels were determined by ELISA in patients with type 1 diabetes (n = 76), LADA (n = 68), type 2 diabetes (n = 77), and their age- and sex-matched controls. The association of serum FGF21 with markers of autoimmunity was studied.


RESULTS
In type 1 diabetic patients, serum FGF21 levels were significantly lower than controls [108.3 (61.5-180.1) vs. 196.0 (103.7-330.9) pg/ml, P < 0.001]. In LADA patients, serum FGF21 levels were significantly lower than controls after adjustment for body mass index [210.9 (121.4-441.6) vs. 268.3 (159.5-443.6) pg/ml, P = 0.003]. By contrast, serum FGF21 levels in type 2 diabetic patients were significantly higher than controls [381.2 (244.7-531.3) vs. 301.4 (173.9-444.2) pg/ml, P = 0.006]. FGF21 levels increased progressively from type 1 diabetes, LADA, to type 2 diabetes (P < 0.001 for global trend). Furthermore, FGF21 levels correlated inversely with titers of glutamic acid decarboxylase and insulinoma-associated protein 2 autoantibodies in type 1 diabetic and LADA patients.


CONCLUSIONS
Serum FGF21 level is increased in type 2 diabetes but decreased in type 1 diabetes and LADA. In autoimmune diabetes, the reduction in circulating FGF21 is closely associated with markers of pancreatic β-cell autoimmunity.
Diabetes Center, Institute of Metabolism and Endocrinology, Second Xiangya Hospital, Key Laboratory of Diabetes Immunology, Ministry of Education, Central South University, Changsha, Hunan 410081, China.
Yang
Y
Xiao
Aimin
A
Xu
Lawrence S C
LS
Law
Cheng
C
Chen
Hui
H
Li
Xia
X
Li
Lin
L
Yang
Shiping
S
Liu
Zhiguang
Z
Zhou
Karen S L
KS
Lam
D000293:Adolescent; D000328:Adult; D000368:Aged; D015551:Autoimmunity / Q000502:physiology; D001786:Blood Glucose / Q000032:analysis; D016022:Case-Control Studies; D002648:Child; D003920:Diabetes Mellitus / Q000097:blood* / Q000145:classification; D003922:Diabetes Mellitus, Type 1 / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood; D005260:Female; D005346:Fibroblast Growth Factors / Q000032:analysis / Q000097:blood*; D006801:Humans; D050417:Insulin-Secreting Cells / Q000276:immunology; D008297:Male; D008875:Middle Aged
D001786:Blood Glucose; C414620:fibroblast growth factor 21; D005346:Fibroblast Growth Factors