Fibroblast growth factor 21 (FGF-21) has been identified as a potent metabolic regulator. Despite the importance of FGF-21 in the regulation of glucose, lipid and energy homeostasis, much less is known about the effect of common anti-diabetic treatment on the plasma levels of FGF-21. The aim of our study was to measure its plasma levels in patients with new-onset type 2 diabetes mellitus (nT2DM) and healthy subjects, and to assess the changes of its circulating levels after pharmacological interventions. One hundred and eleven patients with nT2DM, and 87 gender-, age- and body mass index (BMI)-matched normal glucose tolerance (NGT) controls participated in the study. The patients with nT2DM were treated with mitiglinide for 16 weeks. Biochemical parameters, plasma FGF-21 and insulin levels were measured by commercial ELISA or RIA kits pre- and post-treatment with mitiglinide. Fasting plasma FGF-21 levels were higher in the nT2DM group than in controls (3.21 ± 1.37 vs. 1.52 ± 0.36 μg/L, P<0.01). In nT2DM patients, fasting plasma FGF-21 concentrations were significantly decreased after mitiglinide treatment for 16 weeks (3.21 ± 1.37 vs. 2.79 ± 1.14μg/L, P<0.05), accompanied by significant amelioration of glucose metabolism. Our study showed that mitiglinide treatment decreased plasma FGF-21 levels, and this decrease might be associated with the amelioration of glucose metabolism.
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