IMR Press / RCM / Volume 23 / Issue 5 / DOI: 10.31083/j.rcm2305160
Open Access Original Research
Change of Fibroblast Growth Factor 21 Level Correlates with the Severity of Diabetic Sensory Polyneuropathy after Six-Week Physical Activity
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1 Division of Metabolic Disorders, Department of Internal Medicine, University of Debrecen Faculty of Medicine, 4032 Debrecen, Hungary
2 Doctoral School of Health Sciences University of Debrecen, 4032 Debrecen, Hungary
3 First Department of Internal Medicine, Semmelweis University Faculty of Medicine, 1085 Budapest, Hungary
*Correspondence: sztanekf@yahoo.com (Ferenc Sztanek)
Academic Editors: Osama Hamdy and Joanna Mitri
Rev. Cardiovasc. Med. 2022, 23(5), 160; https://doi.org/10.31083/j.rcm2305160
Submitted: 24 January 2022 | Revised: 11 March 2022 | Accepted: 18 March 2022 | Published: 28 April 2022
(This article belongs to the Special Issue Cardiovascular Benefits of Lifestyle Modification)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Diabetic neuropathy (DN) is a very frequent microvascular complication of type 2 diabetes mellitus (T2DM). Obesity and physical inactivity are well-known risk factors for T2DM. Fibroblast growth factor 21 (FGF21) is a liver-secreted hormone with several beneficial effects on obesity-related metabolic disorders. We aimed to investigate the effect of short-term physical activity on the levels of FGF21, and its correlation with the severity of peripheral sensory polyneuropathy in T2DM patients. Methods: Thirty patients with DN were enrolled in the study, compared to age- and gender-matched controls. We conducted a six-week aerobic training program, which meant treadmill and cycle ergometers three times a week. Anthropometric and laboratory parameters were measured for each patient before and after intervention. Serum levels of FGF21, TNF-alpha, irisin, leptin and adiponectin were measured by ELISA. The sensory perception threshold (CPT) was quantitatively measured using Neurometer®. Results: We found significant decreases in BMI, waist circumference, HbA1c and TNF-alpha levels. From baseline to six-week follow-up, FGF21 levels were significantly increased in DN patients. Significant negative correlations were shown between the changes in FGF21 levels and BMI, between changes in FGF21 and the improvement of CPT values, and between the changes in FGF21 and TNF-alpha levels. There was no difference in irisin, adiponectin and leptin levels in DN patients after aerobic training program. Conclusions: The physical activity may increase the level of FGF21 in T2DM patients with neuropathy. Our results highlight the importance of regular physical activity in the treatment of diabetic neuropathy.

Keywords
diabetic neuropathy
current perception threshold
fibroblast growth factor-21
inflammation
oxidative stress
physical activity
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