The following is a summary of “Circulating FGF21 Concentration, Fasting Plasma Glucose, and the Risk of Type 2 Diabetes: Results From the PREVEND Study,” published in the June 2023 issue of Endocrinology & Metabolism by Post, et al.

Fibroblast growth factor 21 (FGF21) is a peptide hormone that regulates energy balance and is synthesized by various organs. It has been observed that individuals with obesity, insulin resistance, and type 2 diabetes (T2D) tend to have elevated levels of circulating FGF21. Studies in mice have shown that FGF21 levels rise before the onset of insulin resistance. For a study, researchers sought to examine whether FGF21 could serve as an early biomarker for the development of T2D using time-to-event analyses.

A total of 5,244 participants, averaging 52 ± 12 years and comprising 50% males, were included in the study cohort. Circulating FGF21 concentrations were measured using an immunoassay on the Mesoscale U-PLEX assay platform. The main outcome assessed was incident T2D, and Cox proportional hazards models were employed to analyze the associations between circulating FGF21 concentrations and the risk of developing T2D, with adjustments made for potential confounding factors.

The median [interquartile range] circulating FGF21 concentration was 860 [525-1,329] pg/mL. Over a follow-up period of 7.3 [6.1-7.7] years, 299 (5.7%) participants developed T2D. After accounting for various confounding variables, higher circulating FGF21 concentrations were independently associated with an increased risk of incident T2D (hazard ratio per doubling: 1.26 [95% CI, 1.06-1.51]; P = 0.008). Notably, the association between FGF21 and incident T2D was influenced by fasting plasma glucose, which was more pronounced at lower fasting glucose levels (interaction coefficient: −0.12; P = 0.022).

The findings from the study suggested that elevated circulating FGF21 concentrations were independently linked to a higher risk of developing type 2 diabetes, particularly in individuals with lower fasting plasma glucose levels. It indicated the potential of circulating FGF21 concentration as a promising early biomarker for identifying individuals at risk of developing type 2 diabetes.

Source: academic.oup.com/jcem/article/108/6/1387/6932260