Fibroblast growth factor 21 (FGF-21) is a hepatokine primarily produced in the liver with additional synthesis in adipose tissue, skeletal muscle, and the pancreas. FGF-21 is a metabolic hormone that plays a crucial role in regulating glucose and lipid metabolism, energy balance, and insulin sensitivity. FGF-21 exerts its effects through interactions with various tissues, including the liver, adipose tissue, and brain, influencing processes such as glucose uptake, fatty acid oxidation, and energy expenditure. It is regulated by nutritional status and is considered a starvation signal, promoting adaptive responses to metabolic stress.
In clinical and research settings, FGF-21 serves as a valuable biomarker for assessing metabolic disorders and evaluating therapeutic interventions. Elevated serum levels of FGF-21 have been observed in conditions such as obesity, type 2 diabetes mellitus, non-alcoholic fatty liver disease, and chronic kidney disease, often indicating metabolic stress or resistance to its effects . Additionally, FGF-21 has been implicated in cardiovascular health, with higher levels associated with increased carotid intima-media thickness, a marker of atherosclerosis . These associations underscore the potential of FGF-21 as both a diagnostic and prognostic tool in metabolic and cardiovascular diseases. Furthermore, FGF-21 is being explored as a therapeutic target, with studies investigating its role in mitochondrial diseases and renal cancer, highlighting its broader clinical relevance .
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