title: Relationship of serum fibroblast growth factor 21 with abnormal glucose metabolism and insulin resistance: the Baltimore Longitudinal Study of Aging.
abstract: BACKGROUND
  The relationship of fibroblast growth factor 21 (FGF21) with glucose metabolism and insulin resistance has not been well characterized in community-dwelling adults.
  
  
  OBJECTIVE
  The objective of the study was to examine the relationship of FGF21 with glucose metabolism and insulin resistance.
  
  
  METHODS
  Serum FGF21, fasting plasma glucose (FPG), glucose tolerance, and insulin resistance were measured in a cross-sectional study, 2002-2007.
  
  
  METHODS
  The study was the Baltimore Longitudinal Study of Aging, a natural history cohort study of aging in community-dwelling men and women.
  
  
  METHODS
  Seven hundred adults, mean age 63.3 yr, participated in the study.
  
  
  METHODS
  FPG, 2-h plasma glucose, homeostasis model of insulin resistance, whole-body insulin sensitivity (Matsuda index), glucose area under the curve (AUC), and insulin AUC were measured.
  
  
  RESULTS
  Overall, the median (25th and 75th percentiles) FGF21 concentration was 225 (126, 370) pg/ml. The proportion of adults with normal, impaired, and diabetic FPG was 77.0, 21.4, and 1.6%, and those with normal, impaired, and diabetic 2-h plasma glucose was 76.7, 19.1, and 4.1%, respectively. Log serum FGF21 (picograms per milliliter), per 1 sd increase, was associated with an FPG (odds ratio 1.43, 95% confidence interval 1.15, 1.77, P = 0.001) and with 2-h plasma glucose (odds ratio 1.39, 95% confidence interval 1.12, 1.73, P = 0.003), in respective multivariate, ordered logistic regression models, adjusted for potential confounders. Serum FGF21 (picograms per milliliter) was associated with the homeostasis model of insulin resistance, the Matsuda index, glucose AUC, and insulin AUC (all P < 0.0001) in respective multivariable linear regression models adjusted for potential confounders.
  
  
  CONCLUSIONS
  Higher serum FGF21 concentrations were associated with abnormal glucose metabolism and insulin resistance in community-dwelling adults.
authors.affiliation: Department of Opthalmology, Johns Hopkins School of Medicine, Smith Building, 400 North Broadway, M015, Baltimore, Maryland 21287, USA. rdsemba@jhmi.edu
authors.forename: Richard D
authors.initials: RD
authors.lastname: Semba
authors.forename: Kai
authors.initials: K
authors.lastname: Sun
authors.forename: Josephine M
authors.initials: JM
authors.lastname: Egan
authors.forename: Candace
authors.initials: C
authors.lastname: Crasto
authors.forename: Olga D
authors.initials: OD
authors.lastname: Carlson
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrucci
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004219:District of Columbia; D005260:Female; D005346:Fibroblast Growth Factors / Q000097:blood*; D018149:Glucose Intolerance / Q000097:blood* / Q000378:metabolism*; D005951:Glucose Tolerance Test; D006706:Homeostasis; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008137:Longitudinal Studies; D008297:Male; D008396:Maryland; D008875:Middle Aged; D008954:Models, Biological
chemical_list: D001786:Blood Glucose; D007328:Insulin; C414620:fibroblast growth factor 21; D005346:Fibroblast Growth Factors