Plasma omentin-1 levels are significantly decreased in patients with obesity, insulin resistance and diabetes that contribute to the major components of the metabolic syndrome.
[1] Irisin, a newly identified hormone, was first reported by Bostromet al. in 2012, is a novel myokine which plays an important role in the homeostasis, metabolism and energy balance.
It suppresses feeding independently from the leptin pathway and increases insulin secretion from pancreatic beta islet cells.
this is demonstrated by in-vitro studies that Nesfatin-1 stimulates the Preproinsulin mRNA expression and increases the glucose induced insulin release.
There is a study that indicate that HGF/c-Met signalling is essential for maternal β-cell adaptation during pregnancy and that its absence/attenuation leads to gestational diabetes mellitus.
Thus, betatrophin treatment could augment or replace insulin injections by increasing the number of endogenous insulin-producing cells in diabetics.
At the cellular level, the balance between vasodilator (Nitric oxide) and vasoconstrictor (ET-1) actions determines the vascular response to insulin.
[12] ET-1 In addition to its direct vasoconstrictor effects, it causes changes in visceral and perivascular adipose tissue (PVAT), and may contribute to the pathogenesis of both insulin resistance and vascular dysfunction/damage.
Thus, oxidative stress and hypoxia may promote imbalance in the production of vasoactive compounds and may affect vascular homeostasis by activating the ET-1 system.
Systemic administration of FGF-21 reduced plasma glucose and triglycerides to near normal levels in genetically compromised diabetic rodents.
[13] FGF21 can function as a crucial regulator mediating beneficial metabolic effects of therapeutic agents such as metformin, glucagon/glucagonlike peptide1analogues, thiazolidinedione, sirtuin 1 activators, and lipoic acid.
A study showed that when fibroblast growth factor-21 administered daily for 6 weeks to diabetic rhesus monkeys, it caused a dramatic decline in fasting plasma glucose, fructosamine, triglycerides, insulin and glucagon.