The effect of classical life style changes and aerobic exercise program on metabolic parameters and FGF 21 levels in obese patients

FGF 21 is a novel adipokine which suggested to be an important metabolic regulator of glucose and lipid metabolism. Serum FGF 21 levels in overweight /obese subjects were significantly higher than lean individuals. It is also associated with insülin resistance and diabetes mellitus. However its role in the pathogenesis of these diseases remains to be defined. The aim of our study was to measure FGF 21 level in patients with obesity and the relationship between obesity and various cardiometabolic parameters in humans. We examined FGF 21 serum levels in obese individuals without diabetes or secondary caues and changes in FGF 21 levels in response to dietary manipulation and exercise.A hundred eighty four non diabetic obese individuals with BMI ? 30kg/m² were included in the study. Antropometric and biochemical evaluation were carried out and 12 derivation EKG was obtained. Dietary intervention and programmed exercise for three months (with %50 or % 75 of maxium heart rate) was recommended to all participants. Individuals who did not accept to participate in programmed exercise group was adviced an hour of walking for 5 days in a week. Eighty five of participants completed the prospective put of the study. Antropometric, biochemical measurements, serum FGF 21 levels and EKG was repeated in those individuals. We obtained moderate weight loss in sixty one subjects who participated in the study.Baseline FGF levels were positively correlated with BMI, waist circumference, fasting plasma, glucose, trigliseride, plasma insulin, HOMA IR, and adiposity. However FGF 21 levels were not changed by the weight loss. The antropometric and metabolic changes induced by weight reduction did not correlate with baseline FGF 21 levels or changes in the FGF 21 levels.As a result of our study; we found that FGF 21 level was positively correlated with BMI, waist circumference, adiposity and plasma trigliseride levels. In our study its shown that FGF 21 levels were not modified by a moderate weight reduction which was obtained by programmed exercise or dietary intervention. But the mechanism of the relationship between FGF 21 levels and obesity, insulin resistance and adiposity remained unclear. More detailed studies will be required to further anlayse that relation and whether high FGF 21 level is reason or is a result of insulin resistance and related disorders.