FGF21 is not required for glucose homeostasis, ketosis or tumour suppression associated with ketogenic diets in mice
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Aims/hypothesis Ketogenic diets (KDs) have increasingly gained attention as effective means for weight loss and potential adjunctive treatment of cancer. The metabolic benefits of KDs are regularly ascribed to enhanced hepatic secretion of fibroblast growth factor 21 (FGF21) and its systemic effects on fatty-acid oxidation, energy expenditure (EE) and body weight. Ambiguous data from Fgf21-knockout animal strains and low FGF21 concentrations reported in humans with ketosis have nevertheless cast doubt regarding the endogenous function of FGF21. We here aimed to elucidate the causal role of FGF21 in mediating the therapeutic benefits of KDs on metabolism and cancer.Methods We established a dietary model of increased vs decreased FGF21 by feeding C57BL/6J mice with KDs, either depleted of protein or enriched with protein. We furthermore used wild-type and Fgf21-knockout mice that were subjected to the respective diets, and monitored energy and glucose homeostasis as well as tumour growth after transplantation of Lewis lung carcinoma cells.Results Hepatic and circulating, but not adipose tissue, FGF21 levels were profoundly increased by protein starvation, independent of the state of ketosis. We demonstrate that endogenous FGF21 is not essential for the maintenance of normoglycaemia upon protein and carbohydrate starvation and is therefore not needed for the effects of KDs on EE. Furthermore, the tumour-suppressing effects of KDs were independent of FGF21 and, rather, driven by concomitant protein and carbohydrate starvation.Conclusions/interpretation Our data indicate that the multiple systemic effects of KD exposure in mice, previously ascribed to increased FGF21 secretion, are rather a consequence of protein malnutrition.
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Other groups have reported that FGF21 is not required for regulating glucose homeostasis and ketosis induced by ketogenic diets.
“However, these conclusions have been controversial because other groups have reported that FGF21 is not required for regulating glucose homeostasis and ketosis induced by ketogenic diets (97, 123).”
From Fibroblast Growth Factor 21: A Versatile Regulator of Metabolic Homeostasis (2018) · cites this paper as [123]
The effect of high carbohydrate and low protein to increase FGF21 appears to be regulated independently.
“the effect of high carbohydrate and low protein to increase FGF21 appears to be regulated independently”
From FGF21 and the physiological regulation of macronutrient preference (2020) · cites this paper as [163]
The increase in FGF21 is directly related to reduced protein intake, as it occurs in settings of both low and high carbohydrate and low and high fat.
“This increase in FGF21 is directly related to reduced protein intake, as it occurs in settings of both low and high carbohydrate and low and high fat”
From FGF21 and the physiological regulation of macronutrient preference (2020) · cites this paper as [163]
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Signals of energy availability in sleep: consequences of a fat-based metabolism
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The Metabolic Effects of FGF21: From Physiology to Pharmacology
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Macronutrient Composition and Genetic Background Determine the Response to a Ketogenic DietPreprint
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- Authors
- Stemmer, K., Zani, F., Habegger, K. M., Neff, C., Kotzbeck, P., Bauer, M., Yalamanchilli, S., Azad, A., Lehti, M., Martins, P. J. F., Müller, T. D., Pfluger, P. T., & Seeley, R. J.
- Affiliations
- Helmholtz Munich (DE)
- University of Alabama at Birmingham (US)
- University of Cincinnati (US)
- LIKES – Foundation for Sport and Health Sciences (FI)
- University of Michigan (US)
- Corresponding author
- Seeley, Randy J.
- ORCID
- Venue
- Diabetologia
- Published
- 2015-06-23
- Volume
- 58
- Issue
- 10
- Pages
- 2414-2423
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- PMC
- PMC5144740
- OpenAlex
- W2167130564
- Cited by
- 44
- References
- 47
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 3 · 2023: 6 · 2022: 6 · 2021: 3 · 2020: 3 · 2019: 4 · 2018: 6 · 2017: 4 · 2016: 6
- FWCI
- 2.31
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Diabetologia (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Site cant be reached (submittedVersion)
- PuSH - Publication Server of Helmholtz Zentrum München (submittedVersion)
- OPUS (Augsburg University) (submittedVersion)
- Funders
- Deutsche Forschungsgemeinschaft
- National Institutes of Health
- National Cancer Institute (U01CA141464)
- National Institute of Diabetes and Digestive and Kidney Diseases (K01DK098319, T35DK060444)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Fibroblast Growth Factor Research
- Health Sciences › Medicine › Physiology › Dietary Effects on Health
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Keywords
- FGF21, ketogenic diet, glucose homeostasis, ketosis, tumor suppression, protein starvation, protein malnutrition, energy expenditure, FGF21 knockout mice, Lewis lung carcinoma, dietary protein
- MeSH terms
- Adipose Tissue, Animals, Fibroblast Growth Factors, Glucose, Homeostasis, Ketosis, Liver, Neoplasms, Protein Deficiency, Mice, Knockout, Mice, Diet, Ketogenic
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