Assessment of fibroblast growth factor 21 in children with type 1 diabetes mellitus in relation to microvascular complications

INTRODUCTION: Type 1 diabetes mellitus (DM1) represents a growing global health problem with significant morbidity. Fibroblast growth factor 21 (FGF21) is an adipokine expressed predominantly in the liver that plays an important role in metabolic regulation. AIM OF THE STUDY: This study assesses FGF21 levels in children with DM1, in comparison to controls, and correlates them with diabetes duration, glycated haemoglobin (HbA(1c)), and diabetic microvascular complications. MATERIAL AND METHODS: Fifty children with DM1, aged between 5 and 16 years, were studied regarding their diabetes duration, HbA(1c), urinary albumin creatinine ratio (UACR), fundus, and FGF21 level. They were compared to 50 healthy controls. RESULTS: The median FGF21 of the studied children with DM1 was 150 pg/ml, range 50–350 pg/ml; while that of the controls was 35 pg/ml, range 20–50 pg/ml. FGF21 level was significantly higher in children with DM1 than in controls (p < 0.001). Moreover, it was significantly and positively correlated with diabetes duration, mean blood glucose level, and HbA(1c) (p < 0.001, p = 0.015, p = 0.018, respectively). Interestingly, the FGF21 level was not significantly elevated in children with DM1 having diabetic nephropathy and retinopathy (p = 0.122, p = 0.298, respectively). CONCLUSIONS: FGF21 is significantly higher among children with DM1 than in controls. However, its role in diabetic microvascular complications needs further assessment.