FGF-21 and GDF-15 Levels in Patients with Insulin Resistance and It's Relation with Other Biochemical Parameters
Serap Cetiner11Private Clinic, Centermed Plus, İstanbul, Türkiye
Objectives: Since it forms a basis to diabetes, IR, a part of metabolic syndrome, is the most important health problem of our age. Mitochondrial dysfunction and oxidative stress associated with obesity and IR is found in the pathogenesis of metabolic syndrome. This study was concluded in order to analyze whether biomarkers such as fibroblast growth factor 21(FGF-21) and growth differentiation factor 15(GDF-15) which are the indicators of mitochondrial disorder, increased in IR and at the same time in order to research the relation between these cytokines with other biochemical parameters in people with IR. Methods: This cross-sectional prospective study was performed with 101 outpatients with the ages between 18 and 75 years, who applied to a private internal medicine clinic in Istanbul between November 2022 and May 2023. 54 people with IR were selected as the patient group and 47 people without IR were selected as the control group. We evaluated serum FGF-21 and GDF-15 concentrations by ELISA (enzyme-linked immunosorbent assay) in patients with and without IR. At the same time, the relation of these cytokines with other biochemical parameters in people with IR was researched. Results: The mean of FGF-21 and GDF-15 in the IR (+) group were found statistically significantly higher than the IR (-) group (p=0.0001), (p=0.0001). Statistically significant positive correlation was observed between weight, waist circumference (WC), body mass index (BMI), hypertension, aspartate aminotransferase (AST) alanine aminotransferase (ALT), gammaglutamyl transferase (GGT). hemoglobin A1C (HbA1C), uric acid, triglyceride, high-density lipoprotein (HDL) values in the group in which both FGF-21 and GDF-15 values are IR (+). In IR (+) patients, HDL has statistically significant negative correlation with both FGF-21 and GDF-15. In addition, cut-off values for FGF-21 and GDF-15 were developed in this study. The possibility to have IR in a patient with FGF-21>328,76 is found as 22,15 times more likely than a patient with <328,76 FGF-21 with a sensitivity of 96.03% and specificity of 95.65% (p=0.004) (CI: 0,959-1,000). For GDF-15, the possibility to have IR in a patient with GDF-15>120,05 is 14,77 times more than a patient with <120,05 with a sensitivity of 96.03% and specificity of 93.48% (p=0.007) (CI: 0,954-0,997). Conclusion: FGF-21and GDF-15 increases significantly in patients with IR. The determined cut-off values of these two markers have the importance for being used in early diagnosis in IR. At the same time, the analogues to be developed from these markers shall be weapons that can be used against the current IR, diabetes and obesity pandemics. Keywords: FGF-21, GDF-15, Insulin Resistance
Cite This Article
Cetiner S. FGF-21 and GDF-15 Levels in Patients with Insulin Resistance and It's Relation with Other Biochemical Parameters. EJMI. 2023; 7(4): 353-360
Corresponding Author: Serap Cetiner