Introduction: Follistatin is a protein with the ability to neutralize several hormones of the TGF-beta family including activin, bone morphogenetic proteins and myostatin. By inactivating activin, follistatin reduces FSH secretion. Besides ovary, follistatin is produced in several other tissues, hence it may have many other effects. In mice, genetic follistatin defficiency leads to insulin resistance (IR). However, the association between plasma follistatin and directly measured IR has not been evaluated in humans.
Methods: We determined in 81 participants aged 30 to 69 (56% women, 54% overweight, 13% obese) anthropometry, body composition, cardiovascular risk factors and multiple IR indices: Incremental area under the insulin curve, Gutt´s Insulin sensitivity index, homeostatic model assessment – insulin resistance (HOMA-IR) and fasting insulin. A subgroup of 21 participants additionally underwent a hyperinsulinemic/euglycemic clamp. Follistatin and myostatin were measured in fasting plasma using immunometric techniques.
Results: Mean plasma follistatin was 2.517±830 pg/mL, without differences by sex (p=0,55). Follistatin showed a trend towards a positive correlation with the percent lean mass (r=0,19, p=0,088) and towards a negative correlation with percent body fat (r= -0,19, p=0,097). Follistatin was not correlated with OGTT-derived IR indices but it did correlate with whole body insulinstimulated glucose uptake in the clamp (r=0,42, p=0,031). No correlation existed between plasma follistatin and myostatin.
Conclusion: Plasma follistatin showed a trend to a positive correlation with muscle mass, and negative with fat mass. This fits the known role of follistatin as an antagonist to myostatin. Even though follistatin was not associated with indirect IR indices, it was positively associated with directly measured insulin sensitivity in the clamp.
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