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Elevated circulating follistatin associates with an increased risk of type 2 diabetes.


ABSTRACT: The hepatokine follistatin is elevated in patients with type 2 diabetes (T2D) and promotes hyperglycemia in mice. Here we explore the relationship of plasma follistatin levels with incident T2D and mechanisms involved. Adjusted hazard ratio (HR) per standard deviation (SD) increase in follistatin levels for T2D is 1.24 (CI: 1.04-1.47, p < 0.05) during 19-year follow-up (n = 4060, Sweden); and 1.31 (CI: 1.09-1.58, p < 0.01) during 4-year follow-up (n = 883, Finland). High circulating follistatin associates with adipose tissue insulin resistance and non-alcoholic fatty liver disease (n = 210, Germany). In human adipocytes, follistatin dose-dependently increases free fatty acid release. In genome-wide association study (GWAS), variation in the glucokinase regulatory protein gene (GCKR) associates with plasma follistatin levels (n = 4239, Sweden; n = 885, UK, Italy and Sweden) and GCKR regulates follistatin secretion in hepatocytes in vitro. Our findings suggest that GCKR regulates follistatin secretion and that elevated circulating follistatin associates with an increased risk of T2D by inducing adipose tissue insulin resistance.

SUBMITTER: Wu C 

PROVIDER: S-EPMC8580990 | biostudies-literature | 2021 Nov

REPOSITORIES: biostudies-literature

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Elevated circulating follistatin associates with an increased risk of type 2 diabetes.

Wu Chuanyan C   Borné Yan Y   Gao Rui R   López Rodriguez Maykel M   Roell William C WC   Wilson Jonathan M JM   Regmi Ajit A   Luan Cheng C   Aly Dina Mansour DM   Peter Andreas A   Machann Jürgen J   Staiger Harald H   Fritsche Andreas A   Birkenfeld Andreas L AL   Tao Rongya R   Wagner Robert R   Canouil Mickaël M   Hong Mun-Gwan MG   Schwenk Jochen M JM   Ahlqvist Emma E   Kaikkonen Minna U MU   Nilsson Peter P   Shore Angela C AC   Khan Faisel F   Natali Andrea A   Melander Olle O   Orho-Melander Marju M   Nilsson Jan J   Häring Hans-Ulrich HU   Renström Erik E   Wollheim Claes B CB   Engström Gunnar G   Weng Jianping J   Pearson Ewan R ER   Franks Paul W PW   White Morris F MF   Duffin Kevin L KL   Vaag Allan Arthur AA   Laakso Markku M   Stefan Norbert N   Groop Leif L   De Marinis Yang Y  

Nature communications 20211110 1


The hepatokine follistatin is elevated in patients with type 2 diabetes (T2D) and promotes hyperglycemia in mice. Here we explore the relationship of plasma follistatin levels with incident T2D and mechanisms involved. Adjusted hazard ratio (HR) per standard deviation (SD) increase in follistatin levels for T2D is 1.24 (CI: 1.04-1.47, p < 0.05) during 19-year follow-up (n = 4060, Sweden); and 1.31 (CI: 1.09-1.58, p < 0.01) during 4-year follow-up (n = 883, Finland). High circulating follistatin  ...[more]

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