title: FGF21 as a mediator of adaptive responses to stress and metabolic benefits of anti-diabetic drugs.
abstract: Most hormones secreted from specific organs of the body in response to diverse stimuli contribute to the homeostasis of the whole organism. Fibroblast growth factor 21 (FGF21), a hormone induced by a variety of environmental or metabolic stimuli, plays a crucial role in the adaptive response to these stressful conditions. In addition to its role as a stress hormone, FGF21 appears to function as a mediator of the therapeutic effects of currently available drugs and those under development for treatment of metabolic diseases. In this review, we highlight molecular mechanisms and the functional importance of FGF21 induction in response to diverse stress conditions such as changes of nutritional status, cold exposure, and exercise. In addition, we describe recent findings regarding the role of FGF21 in the pathogenesis and treatment of diabetes associated with obesity, liver diseases, pancreatitis, muscle atrophy, atherosclerosis, cardiac hypertrophy, and diabetic nephropathy. Finally, we discuss the current understanding of the actions of FGF21 as a crucial regulator mediating beneficial metabolic effects of therapeutic agents such as metformin, glucagon/glucagon-like peptide 1 analogues, thiazolidinedione, sirtuin 1 activators, and lipoic acid.
authors.affiliation: Severance Biomedical Research InstituteDepartment of Internal MedicineYonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea.
authors.forename: Kook Hwan
authors.initials: KH
authors.lastname: Kim
authors.affiliation: Severance Biomedical Research InstituteDepartment of Internal MedicineYonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea Severance Biomedical Research InstituteDepartment of Internal MedicineYonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea mslee0923@yuhs.ac.
authors.forename: Myung-Shik
authors.initials: MS
authors.lastname: Lee
mesh_terms: D000222:Adaptation, Physiological; D000818:Animals; D002318:Cardiovascular Diseases / Q000503:physiopathology; D003080:Cold Temperature / Q000009:adverse effects; D048909:Diabetes Complications / Q000503:physiopathology; D005346:Fibroblast Growth Factors / Q000502:physiology* / Q000627:therapeutic use; D006706:Homeostasis; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology*; D007674:Kidney Diseases / Q000503:physiopathology; D008659:Metabolic Diseases / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D051379:Mice; D009135:Muscular Diseases / Q000503:physiopathology; D009752:Nutritional Status; D009765:Obesity / Q000209:etiology / Q000503:physiopathology; D010195:Pancreatitis / Q000503:physiopathology; D005082:Physical Exertion; D013312:Stress, Physiological; D022722:Thermogenesis / Q000502:physiology
chemical_list: D007004:Hypoglycemic Agents; C414620:fibroblast growth factor 21; D005346:Fibroblast Growth Factors
keywords: FGF21; adaptation; energy metabolism; metabolic disease; stress