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Acromegaly is associated with high fibroblast growth factor-21 levels

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Abstract

Purpose

Fibroblast growth factor-21 (FGF-21) is a member of fibroblast growth factor family. Both growth hormone (GH) and FGF-21 take place in the regulation of glucose and lipid metabolism. We aimed to investigate FGF-21 levels in acromegaly which is characterized by excess GH levels and is associated with comorbidities and altered body composition.

Methods

We studied 43 subjects (21 females and 22 males, mean age of 50.0 ± 12.8) with acromegaly. The control group consisted of 40 gender- and age-matched subjects (25 females and 15 males, mean age of 48.8 ± 8.8). Acromegaly patients were classified into two groups; active acromegaly (AA; n = 26) and controlled acromegaly (CA; n = 17). Metabolic, anthropometric and laboratory values of subjects were recorded. FGF-21 level was measured by ELISA assay.

Results

Median FGF-21 levels were significantly higher in acromegaly group compared to control group (85.5 vs. 59.0 pg/mL, p = 0.02, respectively). In the multiple regression model, FPG, A1c, HOMA-IR, glucose intolerance, BMI, visceral fat, hs-CRP, presence of hypertension, dyslipidemia and acromegaly were included as independent variables to explain variability of plasma FGF-21 levels in whole study group. The presence of acromegaly was the only determinant of increased FGF-21 levels in the whole study group (β coefficient = 0.253, p = 0.006).

Conclusion

FGF-21 levels were increased significantly in acromegaly group. Increased FGF-21 levels were significantly and independently associated with the state of acromegaly. Acromegaly may also be a FGF-21 resistance state independent from insulin resistance, glucose intolerance, obesity, hypertension and dyslipidemia.

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Funding

This research did not receive any specific grant.

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Authors and Affiliations

  1. Division of Endocrinology, Ege University Faculty of Medicine, Ankara Street, Bornova, Izmir, Turkey

    B. S. Yurekli, N. O. Kutbay, I. Y. Simsir & F. Saygili

  2. Department of Biochemistry, Izmir Bozyaka Education and Research Hospital, Izmir, Turkey

    M. Aksit & G. Bozkaya

  3. Department of Biostatistics, Ege University Faculty of Medicine, Izmir, Turkey

    A. Suner

  4. Department of Nutrition and Dietetics, Ege University Faculty of Medicine, Izmir, Turkey

    S. Seckiner

  5. Division of Endocrinology, Izmir Bozyaka Education and Research Hospital, Izmir, Turkey

    G. U. Kocabas

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  1. B. S. Yurekli
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  2. N. O. Kutbay
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Correspondence to B. S. Yurekli.

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Ethical approval

The study was approved by Ege University Local Ethic Committee. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Written informed consent was obtained from all participants.

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Yurekli, B.S., Kutbay, N.O., Aksit, M. et al. Acromegaly is associated with high fibroblast growth factor-21 levels. J Endocrinol Invest 42, 53–60 (2019). https://doi.org/10.1007/s40618-018-0885-1

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