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KMID : 0882420150880030273
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Korean Journal of Medicine
2015 Volume.88 No. 3 p.273 ~ p.280
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Association between Serum Fibroblast Growth Factor-21 Levels and Nonalcoholic Fatty Liver in Korean Men with Type 2 Diabetes
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Han Yong-Jae
Huh Ji-Hye
Seong Jae-Ho
Lim Jung-Soo
Lee Mi-Young
Chung Choon-Hee
Shin Jang-Yel
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Abstract
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Background/Aims: Serum fibroblast growth factor-21 (FGF-21) levels are elevated in obesity, metabolic syndrome, and type 2 diabetes. Clinical studies have demonstrated an association between FGF-21 and nonalcoholic fatty liver (NAFL) in the general population. This study investigated the association between FGF-21 and NAFL in Korean men with type 2 diabetes.
Methods: Clinical and biochemical metabolic parameters were measured in 135 Korean men with type 2 diabetes (mean age: 56.2 ± 9.2 years; HbA1C: 7.6 ± 1.5%). Serum FGF-21 was determined by enzyme-linked immunosorbent assay. NAFL severity was assessed by ultrasound of the liver. High-grade (hg) NAFL was defined as moderate or severe fatty liver.
Results: The patients were divided into three subgroups according to NAFL severity: normal (17.0%), low-grade (50.4%), and high-grade (32.6%). Patients with hgNAFL had a larger waist circumference and higher body mass index (BMI), homeostatic model assessment-estimated insulin resistance (HOMA-IR) score, and triglyceride (TG), liver enzyme, and FGF-21 levels than those with a normal liver. FGF-21 correlated positively with BMI, serum creatinine (Cr), TG, liver enzymes, and high-sensitivity C-reactive protein, but negatively with high density lipoprotein (HDL). In multivariate regression analysis, Cr and TG were independently associated with FGF-21. BMI, TG, HDL, HOMA-IR, and FGF-21 correlated strongly with hgNAFL. The odds ratio (OR) of a 1-standard-deviation increase in FGF-21 predicting hgNAFL was 2.39 (95% confidence interval, 1.55?3.68). The OR remained significant after adjustment for Cr, TG, BMI, and HOMA-IR.
Conclusions: Our findings suggest an independent association of serum FGF-21 with NAFL in Korean men with type 2 diabetes.
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KEYWORD
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Fibroblast growth factor 21, Fatty liver, Diabetes
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