FGF21 Is Associated with Cognitive Impairments in Non-Elderly Patients

By Maryna Mullerman ’20

Figure 1. FGF21 hormone levels could be used as a marker of cognitive decline in non-elderly population with MetS.


Patients with metabolic syndrome (MetS), associated with cognitive decline, often express elevated levels of fibroblast growth factor 21 (FGF21), an endocrine hormone for metabolic regulation. Arintaya Phrommintikul and researchers from Chiang Mai University in Thailand investigated the link between FGF21 and cognitive decline in elderly and non-elderly patients. They hypothesized that FGF21 levels corresponded with cognitive performance in younger and older patients.

The study involved MetS subjects from a cohort of patients at high risk for atherosclerosis. The patients were divided into a non-elderly group and an elderly group. The patients had to meet three out of five criteria of MetS: elevated fasting glucose levels, high blood pressure, high density lipoproteins, elevated waist circumferences, and high blood glyceride levels. The researchers collected cognitive assessment data using Montreal Cognitive Assessment (MoCA), took blood samples, and conducted physical examinations. Plasma FGF21 levels were calculated using the enzyme-linked immunosorbent assay (ELISA) method. Body mass index (BMI) levels were calculated for each participant and compared to MetS conditions, MoCA scores, and FGF21 levels.
The non-elderly group of MetS patients had a higher average BMI than that of elderly patients. The non-elderly participants’ MoCA scores were positively correlated with BMI scores, waist circumferences, and insulin levels. The scores had a negative association with FGF21 levels. In elderly patients, MoCA scores were positively correlated with BMI levels. Moreover, the cognitive assessment scores were lower in older MetS patients.
The study concluded that FGF21 hormone levels could indicate cognitive decline in non-elderly populations with MetS. Patient age was a significant contributor to the decline in cognition and, consequently, the decrease in MoCA scores. The study identified an important factor in the metabolic syndrome that could potentially be used as a hormonal marker for potential mental decline in non-elderly populations. The study’s limitations included a small pool of participants and multiple confounding variables such as waist circumference and BMI measurements. Understanding pathophysiology of the metabolic syndrome could potentially prevent cognitive decline, Alzheimer’s disease, and dementia. Future research could focus on the role of adiponectin, an important mediator in the metabolic effects of FGF21 hormone, in MetS patient studies.  



  1. A. Phrommintikul, et. al., Factors associated with cognitive impairment in elderly versus nonelderly patients with metabolic syndrome: the different roles of FGF21. Scientific Reports 8, (2018). doi: 10.1038/s41598-018-23550-9.
  2. Image retrieved from: https://www.google.com/search?safe=active&as_st=y&hl=en&tbs=sur%3Afmc&tbm=isch&sa=1&ei=7ITNWuSdFIia_QaqyYXwDQ&q=brain&oq=brain&gs_l=psy-ab.3..0i67k1l2j0j0i67k1j0l4j0i67k1j0.3662.4314.0.4499.….0…1c.1.64.psy-ab..0.5.545.0…62.lxzp94JLJTk#imgrc=OqPhBKLg4XSZMM:

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