Abstract

Background Fibroblast growth factor-21 (FGF21) is an intercellular signaling molecule secreted by metabolic organs, including skeletal muscle, in response to intracellular stress. FGF21 crosses the blood brain barrier and acts via the nervous system to coordinate aspects of the adaptive starvation response, including increased lipolysis, gluconeogenesis, hepatic fatty acid oxidation, and activation of the hypothalamic-pituitary-adrenocortical (HPA) axis. Given its beneficial effects for hepatic lipid metabolism, pharmaceutical FGF21 analogues are in clinical trials treatment of fatty liver disease. We predicted pharmacologic treatment with FGF21 in-creases HPA axis activity and skeletal muscle glucocorticoid signaling and induces skeletal muscle atrophy in mice. Methods We treated male and female mice with FGF21 or saline, delivered either pe-ripherally or directly to the brain, to determine its effect on skeletal muscle. To identify metabolic pathways affected by FGF21, we analyzed untargeted primary metabolites measured in plasma by GCTOF-MS. To determine mechanisms underlying sex-and FGF21-dependent changes in muscle mass, we measured hormonal and molecular mediators of muscle protein synthesis and degradation. We performed stable isotope labeling with deuterium oxide to directly measure muscle protein synthesis. Results A short course of systemic FGF21 treatment decreased muscle protein synthe-sis (P < 0.001) and reduced tibialis anterior weight (P < 0.05); this was driven primarily by its effect in female mice (P < 0.05). Similarly, intracerebroventricular FGF21 reduced TA muscle fiber cross sectional area (P < 0.01); this was more apparent among female mice compared to male littermates (P < 0.05). In agreement with the reduced muscle mass, the topmost enriched meta-bolic pathways in FGF21-treated females were related to amino acid metabolism, and the relative abundance of plasma proteinogenic amino acids were increased up to three-fold (P < 0.05). FGF21 treatment increased hypothalamic Crh mRNA (P < 0.01), plasma corticosterone (P < 0.01), and adrenal weight (P < 0.05), and increased expression of glucocorticoid receptor target genes known to reduce muscle protein synthesis and/or promote degradation including Foxo1, Redd1, and Klf15 (P < 0.05). Again, these changes were driven primarily by effects of FGF21 in females (P < 0.05). Conclusions FGF21 increased plasma amino acids and decreased skeletal muscle mass, together with activation of the HPA axis and glucocorticoid receptor target genes in skeletal muscle—and female mice were more sensitive to all these outcomes. Given the proposed use of FGF21 analogues for the treatment of metabolic disease, the study is both physiologically relevant and may have important clinical implications.