Diagnostic accuracy of fibroblast growth factor-21 (FGF-21) and growth differentiation factor-15 (GDF-15) for predicting insulin resistance using triglyceride-glucose Index, HOMA-C-Peptide, and C-peptide-to-glucose ratio in type 2 diabetes: A systematic review and bivariate diagnostic test accuracy meta-analysis
Study context
- Population
- Type 2 diabetes; insulin resistance by reference standards triglyceride-glucose (TyG) index, HOMA-C-peptide and C-peptide-to-glucose ratio; databases searched January 2015 to March 2025
- Participants
- 14,832 participants15 studies
- Comparison
- FGF-21, GDF-15 and combined FGF-21 + GDF-15 for predicting insulin resistance
- Outcome
- Diagnostic accuracy for predicting insulin resistance
Methodological detailsPRISMA-DTA-compliant
- PRISMA-DTA-compliant
Pooled result
As reported in the abstract
Pooled diagnostic accuracy vs TyG
| Group | AUC | Sensitivity | Specificity |
|---|---|---|---|
| FGF-21 | 0.88 | 82.4% | 78.9% |
| GDF-15 | 0.91 | 85.6% | 82.1% |
| FGF-21 + GDF-15 | 0.94 | 88.9% | 86.4% |
AUC
FGF-210.88
GDF-150.91
FGF-21 + GDF-150.94
Sensitivity
FGF-2182.4%
GDF-1585.6%
FGF-21 + GDF-1588.9%
Specificity
FGF-2178.9%
GDF-1582.1%
FGF-21 + GDF-1586.4%
Further pooled results
Reference standard discrimination
- TyG was the most discriminating reference standard across both biomarkers
Original publication
Diagnostic accuracy of fibroblast growth factor-21 (FGF-21) and growth differentiation factor-15 (GDF-15) for predicting insulin resistance using triglyceride-glucose Index, HOMA-C-Peptide, and C-peptide-to-glucose ratio in type 2 diabetes: A systematic review and bivariate diagnostic test accuracy meta-analysis. Diabetes Res Clin Pract. Published 12 May 2026. doi:10.
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