The role of fibroblast growth factor 21 in metabolic processes in patients with gastrointestinal diseases

Background. Recently, the number of patients with obesity and metabolic syndrome has increased. Numerous studies to find new regulators of metabolic processes have led to the disco­very of a new fibroblast growth factor 21 (FGF21). The purpose of the study was to determine the correlation between FGF21 and meta­bolic processes among patients with gastrointestinal pathology. Materials and methods. The study was conducted in 80 patients with gastrointestinal diseases aged 18 to 66 years, the average age was (39.04 ± 1.03) years. Among the subjects, there were 56 men (70.0 %) and 24 women (30.0 %). Body composition was assessed using the Tanita MC-780MA apparatus (Japan). Serum leptin, FGF21, insulin levels were measured by enzyme-linked immunosorbent assay, and the HOMA-IR was calculated. Free fatty acids in the serum of patients were evaluated on Chromateс Crystal-5000, a gas chromatograph with a flame ionization detector. Results. The study found positive correlations between FGF21 levels and indicators of bioimpedance analysis: body mass index (r = 0.24; p = 0.004), fat mass (r = 0.26; p = 0.01) and visceral fat (r = 0.29; p = 0.01). In addition, a relationship was detected between FGF21 levels and laboratory data: insulin (r = 0.32; p = 0.001), HOMA-IR (r = 0.31; p = 0.001), leptin (r = 0.32; p = 0.001), triglyceride/high-density lipoprotein ratio (r = 0.48; p = 0.0001), and the content of certain free fatty acids. This indicates that FGF21 affects the development of obesity and metabolic disorders. It was found that FGF21 is associated with visceral obesity in patients with digestive diseases (odds ratio = 1.28, p = 0.0022). FGF21 levels above 1,317.5 pg/mL (sensitivity of 71.0 %, specificity of 53.1 %) indicate the presence of visceral obesity in patients with gastrointestinal di­seases. Conclusions. As a result of a comprehensive study, new data were obtained on the role of FGF21 as a key regulator of metabolic disorders, which is confirmed by the established relationships of this indicator with the components of lipid and carbohydrate metabolism disorders, cytokine imbalance, and hormonal activity of adipose tissue in patients with pathology of the digestive system.