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Retrospective analysis of factors associated with serum levels of fibroblast growth factor-21 in patients with diabetes
Open accessAbstract
BACKGROUND: Fibroblast growth factor-21 (FGF-21) plays multiple roles in pathophysiological processes of the human body. Previous studies have evidenced FGF-21 to be an inhibitor of vascular calcification through a variety of mechanisms. Increased levels of serum FGF-21 are known to be associated with an elevated risk of coronary heart disease; however, the factors affecting the expression of FGF-21 are currently unclear. This study aimed to observe the effects of some medications and other factors on serum FGF-21 levels in patients with diabetes. METHODS: Baseline characteristics of patients with diabetes, including body mass index (BMI), medication, level of exercise, and other information, were collected and analyzed, and their baseline levels of serum FGF-21 were tested. The relationship of serum FGF-21 levels with these characteristics was analyzed. RESULTS: A total of 2118 patients were enrolled in the final analysis. Results revealed that the serum levels of FGF-21 in patients with a high BMI were elevated compared to those in patients with a normal or low BMI. Furthermore, the serum levels of FGF-21 in patients who engaged in regular exercise were higher than those in patients who exercised intermittently or not at all. No significant differences existed between patients who received different anti-diabetic drugs, or between patients treated with different antihyperlipidemic drugs. Also, angiotensin-converting enzyme inhibitors and angiotensin receptor blockers had no obvious effects on serum levels of FGF-21 in patients with diabetes. CONCLUSIONS: Drugs used in the treatment of patients with diabetes have no significant effects on serum levels of FGF-21. Obese patients had higher serum levels of FGF-21 than did non-obese patients. Participating in sports might increase the levels of FGF-21 in patients with diabetes.
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“In obesity and type 2 diabetes, FGF21 resistance is common: circulating levels are elevated but receptor signaling is impaired, as documented in human studies [51,52,53].”
From Exercise-Induced Myokines in Obesity-Related Metabolic Disorders and Cardiovascular Protection: A Narrative Review (2026) · cites this paper as [52]
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“Third, the phenomenon of myokine resistance—observed for irisin [42,43] and FGF21 [51,52] in obese and diabetic states—complicates interpretation, as elevated circulating levels may reflect target tissue insensitivity rather than enhanced function.”
From Exercise-Induced Myokines in Obesity-Related Metabolic Disorders and Cardiovascular Protection: A Narrative Review (2026) · cites this paper as [52]
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“Third, the phenomenon of myokine resistance—observed for irisin [42,43] and FGF21 [51,52] in obese and diabetic states—complicates interpretation, as elevated circulating levels may reflect target tissue insensitivity rather than enhanced function.”
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Metadata
- Authors
- Ren, F., Huang, J., Dai, T., & Gan, F.
- Affiliations
- Beijing Aerospace General Hospital (CN)
- Corresponding author
- Gan, Feng
- ORCID
- Gan, Feng
- Venue
- Annals of Palliative Medicine
- Publisher
- AME Publishing Company
- Published
- 2021-03
- Volume
- 10
- Issue
- 3
- Pages
- 3258-3266
- ISSN
- 2224-5820 (ISSN-L)
- 2224-5839
- OpenAlex
- W3145450863
- Cited by
- 8
- References
- 39
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 3
- FWCI
- 0.47
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Annals of Palliative Medicine (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Fibroblast Growth Factor Research
- Health Sciences › Medicine › Nephrology › Parathyroid Disorders and Treatments
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Keywords
- FGF21, diabetes mellitus, obesity, body mass index, physical activity, antidiabetic drugs, lipid-lowering drugs, ACE inhibitors, angiotensin receptor blockers, vascular calcification
- MeSH terms
- Angiotensin-Converting Enzyme Inhibitors, Diabetes Mellitus, Fibroblast Growth Factors, Humans, Retrospective Studies, Angiotensin Receptor Antagonists
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