The Role of Insulin Resistance on FGF-21 and Inflammatory Markers in Obese Adolescents Undergoing Multicomponent Long-Term Weight Loss Therapy

Raquel Munhoz da Silveira Campos,1 Lila Missae Oyama,2,3 Deborah Cristina Landi Masquio,4 Sofia Emanuelle de Castro Ferreira Vicente,2 Flávia Campos Corgosinho,5 Ana Claudia Pelissari Kravchychyn,2 Lian Tock,6 Sergio Tufik,7 Marco Túlio de Mello,8 *Ana R. Dâmaso2

1. Department of Physiotherapy, Therapeutic Resources Laboratory, Universidade Federal de São Carlos (UFSCar), São Carlos, Brazil
2. Post Graduate Program of Nutrition, Paulista Medicine School–Universidade Federal de São Paulo, (UNIFESP), São Paulo, Brazil
3. Department of Physiology, Paulista Medicine School–Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
4. University Center São Camilo, São Paulo, Brazil
5. Universidade Federal de Goiás (UFG), Goiânia, Brazil
6. Weight Science, São Paulo, Brazil
7. Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil
8. School of Physical Education, Physiotherapy and Occupational Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
*Correspondence to

Disclosure: The authors have declared no conflicts of interest.
Acknowledgements: FAPESP (2013/041364; 2013/19046-0; 2013/08522-6; 2015/14309-9; 2017/07372-1), CNPq (573587/2008-6; 300654/2013-8; 150177/2014-3; 409943/2016-9) and CAPES.
Received: 30.01.17 Accepted: 18.08.17
Citation: EMJ. 2017;2[4]:97-105.


Objective: The purpose of this study was to investigate the effects of a long-term weight loss therapy in two groups (insulin resistance [IR] and non-insulin resistance [non-IR]) of obese adolescents based on metabolic profile, biomarkers of inflammation, and fibroblast growth factor-21 (FGF-21) concentrations.

Methods: Obese adolescents (15–19 years) were randomised into two groups (IR=8 and non-IR=9) and monitored through clinical, exercise training, nutritional, and psychological counselling over 1 year. Measurements of inflammatory biomarkers and FGF-21 were performed. The effects of therapy were verified by two-way ANOVA and post hoc analyses were performed (α ≤5%).

Results: A reduction in body mass, visceral fat, and an increase in adiponectin in both groups was found. Only the non-IR group demonstrated improved BMI, body fat mass, lean body mass, and waist circumference. Indeed, in the non-IR group, FGF-21 presence was positively correlated with high-density lipoprotein cholesterol and lean body mass and inversely correlated with plasminogen activator inhibitor-1 and triglycerides. In the IR group, there was a reduction in FGF-21 concentration, adiponectin/leptin ratio, insulin, total cholesterol, low-density lipoprotein cholesterol, and plasminogen activator inhibitor-1. FGF-21 was negatively correlated with delta-triglycerides, waist circumference, and low-density lipoprotein cholesterol. The IR prevalence reduced from 47% to 23.5% in the studied population.

Conclusions: Although the multicomponent clinical approach improves, in both analysed groups and in both metabolic and inflammatory states, the presence of IR resulted in a reduction in both FGF-21 concentration and adiponectin/leptin ratio. Additionally, in the IR group, FGF-21 was negatively correlated with proinflammatory markers, and in the non-IR group it was positively associated with high-density lipoprotein, suggesting its role in the control of inflammation counteracting IR. In this way, we suggest that IR can impair the anti-inflammatory effects of FGF-21. It will be helpful if these results can be confirmed in a large cohort, underlying physiological mechanisms to explore how these results can help in setting up more prospective studies.

This article is made available under the terms of the Creative Commons Attribution-Non Commercial 4.0 License.

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