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Korean J Med > Volume 88(3); 2015 > Article
The Korean Journal of Medicine 2015;88(3): 273-280.
한국 제2형 당뇨병 남성에서 FGF-21과 비알코올성 지방간의 연관성
한용재, 허지혜, 성재호, 임정수, 이미영, 정춘희, 신장열
연세대학교 원주의과대학 내과학교실
Association between Serum Fibroblast Growth Factor-21 Levels and Nonalcoholic Fatty Liver in Korean Men with Type 2 Diabetes
Yong Jae Han, Ji Hye Huh, Jae Ho Seong, Jung Soo Lim, Mi Young Lee, Choon Hee Chung, Jang Yel Shin
Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
Corresponding Author: Jang Yel Shin ,Tel: +82-33-741-0509, Fax: +82-33-731-5884, Email: sjy3290@yonsei.ac.kr
Received: 2014. 5. 21;  Accepted: 2014. 9. 22.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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.
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.
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.
Our findings suggest an independent association of serum FGF-21 with NAFL in Korean men with type 2 diabetes.
Keywords: Fibroblast growth factor 21; Fatty liver; Diabetes
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