FGF21/adiponectin ratio predicts deterioration in glycemia: a 4.6-year prospective study in China

Cardiovascular Diabetology

Qichen Fang¹  Lingling Qian¹  Liang Wu¹  Xuhong Hou¹  Jiacheng Ni¹  Huating Li¹  Weiping Jia¹  Qiongmei Gao¹  Dan Liu²  Xiaoxue Long² 

[1] Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, 200233, Shanghai, China;Department of Endocrinology and Metabolism, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, 600 Yishan Road, 200233, Shanghai, China;Department of Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China;

关键词: Fibroblast growth factor 21;    Adiponectin;    FGF21/Adiponectin ratio;    Biomarker;    New-onset diabetes;    Prediabetes;    Deterioration in glycemia;   

DOI  :  10.1186/s12933-021-01351-1

来源: Springer

【 摘 要 】

BackgroundThe fibroblast growth factor (FGF) 21-adiponectin pathway is involved in the regulation of insulin resistance. However, the relationship between the FGF21-adiponectin pathway and type 2 diabetes in humans is unclear. Here, we investigated the association of FGF21/adiponectin ratio with deterioration in glycemia in a prospective cohort study.MethodsWe studied 6361 subjects recruited from the prospective Shanghai Nicheng Cohort Study in China. The association between baseline FGF21/adiponectin ratio and new-onset diabetes and incident prediabetes was evaluated using multiple logistic regression analysis.ResultsAt baseline, FGF21/adiponectin ratio levels increased progressively with the deterioration in glycemic control from normal glucose tolerance to prediabetes and diabetes (p for trend < 0.001). Over a median follow-up of 4.6 years, 195 subjects developed new-onset diabetes and 351 subjects developed incident prediabetes. Elevated baseline FGF21/adiponectin ratio was a significant predictor of new-onset diabetes independent of traditional risk factors, especially in subjects with prediabetes (odds ratio, 1.367; p = 0.001). Moreover, FGF21/adiponectin ratio predicted incident prediabetes (odds ratio, 1.185; p = 0.021) while neither FGF21 nor adiponectin were independent predictors of incident prediabetes (both p > 0.05). Furthermore, net reclassification improvement and integrated discrimination improvement analyses showed that FGF21/adiponectin ratio provided a better performance in diabetes risk prediction than the use of FGF21 or adiponectin alone.ConclusionsFGF21/adiponectin ratio independently predicted the onset of prediabetes and diabetes, with the potential to be a useful biomarker of deterioration in glycemia.

【 授权许可】

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