Edited by John M. DenuPrevious studies have shown that glucagon cooperatively interacts with insulin to stimulate hepatic FGF21 gene expression. Here we investigated the mechanism by which glucagon and insulin increased FGF21 gene transcription in primary hepatocyte cultures. Transfection analyses demonstrated that glucagon plus insulin induction of FGF21 transcription was conferred by two activating transcription factor 4 (ATF4) binding sites in the FGF21 gene. Glucagon plus insulin stimulated a 5-fold increase in ATF4 protein abundance, and knockdown of ATF4 expression suppressed the ability of glucagon plus insulin to increase FGF21 expression. In hepatocytes incubated in the presence of insulin, treatment with a PKA-selective agonist mimicked the ability of glucagon to stimulate ATF4 and FGF21 expression. Inhibition of PKA, PI3K, Akt, and mammalian target of rapamycin complex 1 (mTORC1) suppressed the ability of glucagon plus insulin to stimulate ATF4 and FGF21 expression. Additional analyses demonstrated that chenodeoxycholic acid (CDCA) induced a 6-fold increase in ATF4 expression and that knockdown of ATF4 expression suppressed the ability of CDCA to increase FGF21 gene expression. CDCA increased the phosphorylation of eIF2␣, and inhibition of eIF2␣ signaling activity suppressed CDCA regulation of ATF4 and FGF21 expression. These results demonstrate that glucagon plus insulin increases FGF21 transcription by stimulating ATF4 expression and that activation of cAMP/PKA and PI3K/Akt/mTORC1 mediates the effect of glucagon plus insulin on ATF4 expression. These results also demonstrate that CDCA regulation of FGF21 transcription is mediated at least partially by an eIF2␣-dependent increase in ATF4 expression.FGF21 is an atypical member of the fibroblast growth factor family that lacks the ability to bind to heparin sulfate proteoglycans, allowing it to escape the extracellular matrix and function in an endocrine manner (1-3). Studies investigating the biological action of FGF21 have shown that starvation and other nutritional stresses (e.g. dietary protein restriction, consumption of a high-fat, low-carbohydrate ketogenic diet, and consumption of a high-fat obesogenic diet) stimulate an increase in the expression and secretion of FGF21 by the liver, the predominant site of FGF21 production in the body (4 -10). FGF21 signals through FGF receptor 1c (FGFR1c) linked to the co-receptor -klotho to increase food intake, energy expenditure, gluconeogenesis, and insulin sensitivity and inhibit growth and female fertility in response to nutritional stress (1-6, 11).Several signaling pathways have been identified that mediate the effects of nutritional stress on FGF21 expression. One such pathway involves the activation of the nuclear receptor peroxisome proliferator-activated receptor ␣ (PPAR␣).2 A PPAR␣ response element (PPRE) has been identified in the 5Ј-flanking region of the murine and human FGF21 genes (8, 12). Ablation of the PPAR␣ gene suppresses the ability of starvation and ketogenic diet consumption to incr...