Fibroblast Growth Factor 21 Is an Early Predictor for Prediabetes in Egyptian Population

Presentation Number: MON 505
Date of Presentation: April 3rd, 2017

D.sahar hossam Elhini Sr.1, Ragaa Abdelshaheed Matta*2, Mahmoud saad Abdelaleem3, Hanan mostaffa Kamel4 and Ahmed abdelfadil Said5
1medical school, Minia, EGYPT, 2Medical School, Minia, Egypt, 3medical school Elminia, minia, Egypt, 4medical school ELminia, 5medical schooli elminia univeristy, minia, Egypt

Abstract

Fibroblast growth factor 21 (FGF21) is an innovative heptokine that improves glucose and lipid metabolism and insulin sensitivity in addition to its anti atherosclerotic effects, we investigated serum FGF21 levels in in newly diagnosed, drug -navi patients with prediabetes ( n=60) and DMT2(n=60) in in addition to 40 healthy subjects as a control group; and explored its relationships with anthropometric, metabolic, insulin resistance, hepatic and renal parameters, and CVD risk score; and to asses predictors of FGF21 level in these patients. All subjects underwent anthropometric measurements, routine biochemical assay including lipid profile. Evaluation of HbA1c, fasting insulin, albumin creatinine ratio (ACR) and ELISA assessed serum FGF21 levels. HOMA-IR, estimated glomular filtration rate and CVD risk score were calculated Serum FGF21 levels were significantly increased in pre-diabetic and diabetic subjects compared with healthy control (231.7 ±59.3, 260.4 ±82.5 versus 22.6 ± 5.31 pg/dl, p<0.001 for both). Also diabetic patients had statistically significant higher FGF21 levels than pre-diabetic patients (p=0.03).ROC curve analysis identified FGF21 cut off value of >204 and > 30pg/ml for diagnosis of DMT2 and prediabetes with AUC 0.72 and 1, sensitivity of 82.5% and 100% and specificity of 60% and 100% respectively).Using univariate analysis , FGF21 was positively correlated with BMI, waist circumference, fasting blood sugar, 2h postprandial blood sugar , HOMA-IR, triglyceride, cholesterol and liver enzymes and negative correlated to HDL-c in entire and individual studied patient groups, It was positively correlated with ACR among diabetic group. Multiple regression analysis with FGF21 as dependent variable revealed that fasting insulin, TG, BMI, fasting glucose and waist hip ratio in pre-diabetic group and TG, ACR, age, systolic BP, fasting glucose and fasting insulin in diabetic group were significant contributors to FGF21 level, FGF21 was positively correlated to CVD risk score in diabetic and prediabetic groups, We concluded that FGF21 is an excellent predictor for prediabetes and sensitive predictor for DMT2. It is associated with metabolic, glycemic, hepatic and renal parameters .Metabolic syndrome parameters, fasting insulin and ACR were predictor to FGF21 levels in these patients.

 

Nothing to Disclose: DSHE Sr., RAM, MSA, HMK, AAS