Fibroblast growth factor 21: effects on carbohydrate and lipid metabolism in health and disease

Purpose of review The review summarizes recent findings examining the effects of fibroblast growth factor (FGF) 21 on carbohydrate and lipid metabolism with emphasis on publications from 2010. Recent findings FGF21 is considered to be a metabolic hormone rather than a traditional growth factor. Recent studies identified the important role of FGF21 in regulation of energy balance. Thus, the protein regulates hepatic metabolism and improves insulin sensitivity. Furthermore, central FGF21 action in the brain increases energy expenditure and insulin sensitivity in rodents. Interestingly, FGF21 expression is elevated in the adaptive response to fasting but also regulated by feeding-induced mechanisms. Moreover, FGF21 levels are elevated in obese animals and positively correlate with BMI in humans suggesting obesity as a FGF21-resistant state. Summary FGF21 is a metabolic hormone that is regulated by nutritional status and influences glucose and lipid metabolism by central and peripheral mechanisms. Future research is needed to expand our understanding of the diagnostic and therapeutic relevance of FGF21-dependent pathways in humans.