| Background and ObjectionFibroblast growth factor 21(FGF21)is a newly discovered special member of the fibroblast growth factor family as a pantasomatous metabolic regulator.FGF21 is mainly expressed in liver,adipose tissue,pancreas and skeletal muscle and causes weight loss and increases insulin sensitivity.Studies have found that FGF21 is associated with diabetes,obesity,hyperlipidemia,non-alcoholic fatty liver disease,metabolic syndrome,polycystic ovary syndrome and other metabolic disorders.Studies show that increased expression of FGF21 in the patients of obesity and type 2 diabetes mellitus,but the exact physiological role in human remain unclear.This study is aimed to assess FGF21 level in type 2 diabetic patients with obesity and to explore the possibility that FGF21 could be applied to clinic as risk factor of diabetes,obesity and other related diseases.MethodsNinety patients with type 2 diabetes mellitus(T2DM)who were hospitalized in the Affiliated Hospital of Yangzhou University from March 2016 to December 2016 were selected.None of them had hypertension.And 30 healthy people accepting physical examination in the medical center of the same hospital were included in control group.The subjects of T2DM were divided into two groups,51 overweight patients and 39 normal weight patients according to body mass index(BMI).Basic clinical information and laboratory results of members in each group were recorded.The levels of neck circumference(NC),waist circumference(WC),waist-hip ratio(WHR),total cholesterol(TC),triglycerid(TG),LDL-C,HDL-C,fasting plasma glucose(FPG),HbAlc,C-Peptide,FGF21 and carotid intima-media thickness(CIMT)were compared among groups.The levels of FGF21 were measured by ELISA.The relevant factors of FGF21 were analyzed by Person correlation analysis.Multiple factor logistic regression was used to analyze the risk factors.P<0.05 was considered statistically significant.ResultsThere were no differences in Sex,Age,urea acid(UA),TC,LDL-C among 3 groups(P>0.05);There were differences in serum levels of BMI,NC,WC,WHR,CIMT,FPG,HbAlc,TG,HDL-C,C-Peptide and FGF21 among 3 groups(P<0.05);The serum FGF21 levels in T2DM group were significantly higher than those in control group.According to result of Spearman and Pearson correlation analysis,NC,WC,WHR,TG were positively correlated with serum FGF21 level(r value was 0.205,0.291,0.392 and 0.233,respectively;P<0.05 and P<0.01);BMI,WC,WHR,CIMT,UA,TG,C-P were positively correlated with NC level(r value was 0.628,0.680,0.533,0.507,0.259,0.260 and 0.274,respectively;P<0.01),serum levels of HDL-C was negatively correlated with NC level(r value was-0.342;P<0.01).Sex,BMI,WC,WHR were positively correlated with CIMT level(r value was 0.180,0.343,0.422 and 0.359,respectively;P<0.05 and P<0.01),serum levels of HDL-C was negatively correlated with CIMT level(r value was-0.216,P value was 0.018).Multiple logistic regression analysis demonstrates that FGF21(OR=1.004,P = 0.044)、FPG(OR =40.275,P<0.01)was signficantly associated with type 2 diabetes mellitus.Conclusion(1)The serum FGF21 level increased in type 2 diabetes mellitus patients,which indicated that FGF21 might be used as a risk factor of type 2 diabetes mellitus;(2)FGF21 levels were correlated with NC,WC,WHR,TG.This suggested the FGF21 is associated with obesity and dyslipidemia in type 2 diabetes mellitus patients;(3)The NC levels were increased in type 2 diabetes mellitus patients and associated with WC and WHR,it may be possible to replace the latter 2 parameters as a more easily detected paremeter of abdominal obesity;(4)NC was associated with CIMT,which may be used as a predictor of cardiovascular risk in diabetes mellitus,early screening neck circumference of diabetic patients,early detecting the high risk population of cardiovascular complications. |
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