Fibroblast growth factor 21 – current point of view on its role in physiology of the organism and the pathogenesis of diabetes mellitus and obesity

Fibroblast growth factor 21 (FGF21) belongs to the heterogenic FGF proteins family.  It plays important role in the carbohydrate and lipid metabolism. It is produced by hepatocytes, white adipose tissue, pancreatic and skeletal muscle cells. That hormone stimulates gluconeogenesis, free fatty acids oxidation and ketogenesis in liver. Transcription factors found in liver (PPAR-α) and in adipocytes (PPAR-γ) control its cellular expression. Elevated level of serum FGF21 is associated with some diseases, in which crucial mechanism in their pathogenesis is insulin resistance: obesity, diabetes mellitus, impaired glucose tolerance and metabolic syndrome. Metabolic pathways in liver and white adipose tissue are regulated by some other hormones (leptin, adiponectine, omentin, resistin, vaspin, visfatin, apelin and chemerin) and G3PP enzyme. These substances play important role in the development of diseases connected with the disorders of the carbohydrate and lipid metabolism. Currently FGF21 is being investigated as the potential drug in the insulin resistance treatment. The article aims to present the potential clinical significance of fibroblast growth factor 21 with particular emphasis of the impact on the function of the endocrine system.