Evidence map›Paper›PMID 41877304›Full record

ArticleDiabetes & metabolism journal2026

Influence of Fibroblast Growth Factor 21 on Delayed Glycemic Improvement Following Acute Exercise in Type 2 Diabetes Mellitus.

Ying Zhang, Dan Liu, Yurun Lu, Piao Kang, Xinyu Liu, Qinyi Wang, Anran Chen, Di Cheng, Liang Wu, Qi Li and 12 more

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Article in Diabetes & metabolism journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1 citing paper in PubMed.

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5 · Who and what money

Authors and funding

22 authors.

Ying Zhang *Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Institute for Proactive Healthcare, Shanghai Jiao Tong University, Shanghai, China.
Dan Liu *Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Institute for Proactive Healthcare, Shanghai Jiao Tong University, Shanghai, China.
Yurun Lu *Center for Excellence in Mathematical Sciences, National Center for Mathematics and Interdisciplinary Sciences, Hua Loo-Keng Center for Mathematical Sciences, Key Laboratory of Management, Decision and Information System, Academy of Mathematics and Systems Science, Chinese Academy of Sciences, Beijing, China.
Piao Kang *Department of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Institute for Proactive Healthcare, Shanghai Jiao Tong University, Shanghai, China.
Xinyu LiuCAS Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, China.
Qinyi WangDepartment of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Institute for Proactive Healthcare, Shanghai Jiao Tong University, Shanghai, China.
Anran ChenDepartment of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Institute for Proactive Healthcare, Shanghai Jiao Tong University, Shanghai, China.
Di ChengDepartment of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Institute for Proactive Healthcare, Shanghai Jiao Tong University, Shanghai, China.
Liang WuDepartment of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Institute for Proactive Healthcare, Shanghai Jiao Tong University, Shanghai, China.
Qi LiCAS Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, China.
Xiaolin WangCAS Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, China.
Yanli LiCAS Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, China.
Yaorui YeCAS Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, China.
Jingyi YangDepartment of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Institute for Proactive Healthcare, Shanghai Jiao Tong University, Shanghai, China.
Jiacheng NiDepartment of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Institute for Proactive Healthcare, Shanghai Jiao Tong University, Shanghai, China.
Qichen FangDepartment of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Institute for Proactive Healthcare, Shanghai Jiao Tong University, Shanghai, China.
Zhe HuangDepartment of Genetics and Developmental Science, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China.
Aimin XuThe State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Hong Kong, China.
Weiping JiaDepartment of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Institute for Proactive Healthcare, Shanghai Jiao Tong University, Shanghai, China.
Yong WangCenter for Excellence in Mathematical Sciences, National Center for Mathematics and Interdisciplinary Sciences, Hua Loo-Keng Center for Mathematical Sciences, Key Laboratory of Management, Decision and Information System, Academy of Mathematics and Systems Science, Chinese Academy of Sciences, Beijing, China. ywang@amss.ac.cn.
Guowang XuCAS Key Laboratory of Separation Science for Analytical Chemistry, Dalian Institute of Chemical Physics, Chinese Academy of Sciences, Dalian, China. xugw@dicp.ac.cn.
Huating LiDepartment of Endocrinology and Metabolism, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Institute for Proactive Healthcare, Shanghai Jiao Tong University, Shanghai, China. huarting99@sjtu.edu.cn.

Funding

Excellent Young Scientists Fund of National Natural Science Foundation of China 82022012Exploration Fund Grant of Shanghai Sixth People's Hospital ynts202003General Fund of National Natural Science Foundation of China 82270907Innovative Research Team of High-level Local Universities in Shanghai SHSMU-ZDCX20212700Major Program of National Natural Science Foundation of China 92357305National Key Research and Development Program of China 2022YFA1004804National Natural Science Foundation of China 82100879National Natural Science Foundation of China 82500987Shanghai Municipal Key Clinical Specialty 2017ZZ01013Shanghai Pujiang Program 2020PJD044Shanghai Research Center for Endocrine and Metabolic Diseases 2022ZZ01002Youth Innovation Promotion Association of the Chinese Academy of Sciences 2021186
6 · The paper itself

Abstract

backgruoundExercise positively influences glycemic control. Some individuals experience greater glycemic stability on the day after exercise, even without additional physical activity. However, the mechanisms underlying this delayed glycemic improvement remain unclear.

methodsSeventy-one patients with type 2 diabetes mellitus were assigned to either a 60-minute exercise group or a resting group. Serum fibroblast growth factor 21 (FGF21) levels and untargeted metabolomic profiles were assessed at multiple time points before and after exercise. Interstitial glucose levels were monitored using continuous glucose monitoring system. FGF21 knockout mice and wild-type littermates fed a high-fat diet underwent a 3-week exercise intervention and received FGF21 supplementation.

resultsIndividuals exhibiting delayed glycemic improvement (responders) displayed a significantly stronger FGF21 response than non-responders. Baseline metabolites, including p-cresol sulfate and dimethylglycine, differed between responders and non-responders and were associated with the FGF21 response. Longitudinal time-series analyses revealed post-exercise differences in acylcarnitines, fatty acids, and complex lipids between responders and non-responders. Dynamic correlation and mediation analyses supported the role of FGF21 in modulating delayed glycemic improvement through regulation of lipid metabolism. In vivo FGF21 knockout and rescue experiments demonstrated that FGF21 is necessary for these metabolic shifts and the associated improvements in glucose tolerance and insulin sensitivity.

conclusionThis study suggests that the baseline metabolome is associated with the magnitude of the post-exercise FGF21 response, which influences delayed glycemic improvement through regulation of lipid metabolism pathways.

Indexed as

Blood GlucoseDiabetes Mellitus, Type 2ExerciseFibroblast Growth FactorsAgedAnimalsContinuous Glucose MonitoringFemaleGlycemic ControlHumansLipid MetabolismMaleMiceMice, KnockoutMiddle AgedBlood GlucoseFGF21 protein, humanfibroblast growth factor 21Fibroblast Growth FactorsContinuous glucose monitoringDiabetes mellitus, type 2ExerciseFibroblast growth factor 21Glycemic control

Identifiers

PMID41877304
PMCPMC13366163

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