FGF21 in Adipose Tissue Fibrosis, Obesity and Type 2 Diabetes

To investigate the participation of fibroblastic growth factor 21 (FGF21) in adipose tissue fibrosis, obtain the course of FGF21 serum levels after bariatric surgery and assess the relation of FGF21 to surgery-elicited alleviation of glucose metabolism and weight loss.

In a longitudinal study including subjects undergoing bariatric surgery (RYGB n = 189; VSG n = 17), we measured FGF21 serum levels over three time-points and collected preoperative biopsies of subcutaneous adipose tissue (scAT). We characterized degrees of scAT fibrosis using the FAT score and performed gene expression analyses. In a cross-sectional study (n = 507), we detected serum FGF21 (pg/ml) and performed food frequency questionnaire. Links between the FAT score, weight loss, eating behavior and FGF21 expression were tested in univariate and multivariate models.

We observed a positive association of circulating FGF21 to sweet preference (p < 0.001), total caloric intake (p = 0.034) and addictive behavior (Alcohol: p = 0.017, Smoking: p = 0.032). Moreover, serum FGF21 inversely correlated with FGF21 receptor expression in scAT (p = 0.021). Expression of FGF21 increased with more pronounced tissue fibrosis. Subjects with more pronounced changes in FGF21 levels between time-points displayed greater weight loss (p < 0.001; p = 0.003). Improvement of glucose metabolism in response to the intervention was driven by baseline FGF21 levels (Standardized β: -0.669; corrected R2: 0.41).

We here demonstrate a relationship between FGF21 serum levels, food preference, markers of metabolic disease and adipose tissue fibrosis, but also show its potential in predicting bariatric surgeries’ success.

Publication History

Article published online:
19 August 2021