Fibroblast Growth Factor 21 in Obese Children with Metabolic Associated Fatty Liver Disease | ||
| Pediatric Sciences Journal | ||
| Articles in Press, Accepted Manuscript, Available Online from 10 September 2025 PDF (694.71 K) | ||
| Document Type: Original Research | ||
| DOI: 10.21608/cupsj.2025.326448.1150 | ||
| Authors | ||
| Zeinab A. El Kabbany1; Ayat M. Sayih2; Menat Allah Ali Shaaban3; Nadin N. Toaima* 1 | ||
| 1Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt | ||
| 2Department of Pediatrics, Manshiyet El Bakry Hospital, Cairo, Egypt | ||
| 3Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt | ||
| Abstract | ||
| Background: Fibroblast growth factor 21 (FGF21) is an endocrine hormone expressed by the liver. It boosts glucose and lipid metabolism, and insulin sensitivity. Aim of the work: study the accuracy of FGF21 in diagnosis of metabolic associated fatty liver disease (MAFLD) in obese children. Subjects and Methods: Children recruited from the Obesity Clinic, Children's Hospital, Ain- Shams University were enrolled in the study. Anthropometric data, biochemical test results; including liver function tests, fasting lipid profile, serum glucose, serum insulin, insulin resistance -assessed by calculating HOMA-IR-, liver ultrasound score for MAFLD, and FGF21 levels were analyzed by ELISA. Patients were subdivided by ultrasound into group A obese children with normal liver and group B obese children with fatty liver. Results: This study included 39 (60%) males and 26 (40%) females, with mean ± SD age of 10.17 ± 2.54 years. Their body mass index (BMI) standard deviation score (SDS) was 3.36 ± 0.61, the mean waist/hip ratio (W/H ratio) was 0.93 ± 0.12, mean± SD systolic blood pressure was 1.36 ± 1.47 and diastolic blood pressure was 1.76 ± 0.84. 32 (49%) cases had insulin resistance (mean HOMA-IR = 3.81 ± 3.01), 21(32%) fulfilled the criteria of metabolic syndrome and 27 (41.5%) had MAFLD. Group A included 38 (58.8%) cases, and group B included 27 (41.5%) cases. Patients in group B had statistically higher SDS of BMI, SDS of waist circumference, SDS of hip circumference (p-value= < 0.001, p < 0.001, and p < 0.001 respectively). In group A 12 (31.5%) had dyslipidemia, 1(2.6%) had elevated TG and low HDL, 2 (5.3%) had elevated cholesterol and elevated LDL, 7 (18.4%) had elevated LDL and 2 (5.3%) had low HDL, while in group B, 22 (81.4%) had dyslipidemia, 10 (37%) had elevated TG, 16 had low HDL, 20 (74%) had increased LDL and 7(25%) had increased cholesterol (p=0.001). Mean FGF21 was 169.08 ± 153.68 pg/dl after 12 hours fasting (normal value= up to 115 pg/dl in children. Mean ± SD FGF21 in group A was 96.05 pg/dl ± 39.70 with median 90 pg/dl, while mean FGF21 in group B was 271.85 pg/dl ± 192.69 SD with median 180 pg/dl (p=0.001). FGF21 cutoff value of 115 pg/dl was diagnostic of fatty liver with sensitivity of 88.9%, specificity of 73.7% (p=0.001). FGF-21 correlated positively with US finding (p=0.001). Conclusion: Obese children with MAFLD had higher levels of FGF21. FGF21 value of 115 pg/dl may be added as a non-invasive biomarker for the diagnosis of MAFLD in obese children. | ||
| Keywords | ||
| Children; obesity; FGF21; metabolic associated fatty liver disease | ||
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