Association of serum fibroblast growth factor 21 and urinary glucose excretion in hospitalized patients with type 2 diabetes

Abstract Aim Urinary glucose excretion (UGE) is mainly regulated by the sodium glucose cotransporter (SGLT) -2 in the proximal tubule of kidney. Lowered UGE was associated with higher extent of insulin resistance in patients with type 2 diabetes. Animal studies suggested the relation of Fibroblast growth factor 21 (FGF21) and UGE. However, little was known about the association of FGF21 and UGE in human. We conducted a study to investigate the association of serum FGF21 and low UGE in patients with type 2 diabetes. Method A cohort of 2066 hospitalized patients with type 2 diabetes was screened for the fasting urinary glucose concentration and fasting blood glucose in the medical records. 70 patients with high UGE and 61 patients with Low UGE were analyzed. Frozen serum samples were used for the test of FGF21 levels. Results The body mass index (BMI) and serum FGF21 levels were higher in low UGE group. Multivariable logistic regression indicated the association of FGF21 and low UGE after adjusting for age, sex, renal function, fasting plasm glucose, the treatment of insulin, and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) index. Conclusion Higher serum FGF21 levels were independently associated with low UGE in patients with type 2 diabetes.