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Serum FGF21 increases with hepatic fat accumulation in pediatric onset intestinal failure

Annika Mutanen1, Päivi Heikkilä2, Jouko Lohi2

  • 1Section of Pediatric Surgery, Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland.

Journal of Hepatology
|September 12, 2013
PubMed

Insights

Elevated serum FGF21 levels in pediatric intestinal failure (IF) patients indicate liver steatosis. This finding, linked to parenteral nutrition duration and small bowel length, suggests FGF21 may aid in diagnosing liver steatosis in IF.

Area of Science:

  • Endocrinology
  • Hepatology
  • Pediatric Gastroenterology

Background:

  • Fibroblast Growth Factor 21 (FGF21) is implicated in glucose and lipid metabolism and liver steatosis.
  • Pediatric onset intestinal failure (IF) presents unique metabolic challenges.
  • Understanding FGF21's role in IF is crucial for managing associated complications.

Purpose of the Study:

  • To evaluate serum FGF21 levels in children with intestinal failure (IF).
  • To determine the association between FGF21 levels and liver steatosis in pediatric IF.
  • To explore the relationship between FGF21, liver steatosis, and clinical factors in IF.

Main Methods:

  • Serum FGF21 was measured in 35 pediatric IF patients and 59 healthy controls.
  • Liver biopsies were performed on 30 IF patients to assess steatosis and fibrosis.
  • Statistical analyses, including multivariate regression, were used to correlate FGF21 levels with clinical and histological findings.

Main Results:

  • Serum FGF21 levels were significantly higher in IF patients compared to controls.
  • Patients with liver steatosis exhibited markedly higher FGF21 concentrations and more advanced liver fibrosis.
  • FGF21 levels correlated with the grade of steatosis and were associated with parenteral nutrition duration and remaining small bowel length.

Conclusions:

  • Increased serum FGF21 in pediatric IF reflects liver steatosis.
  • Both FGF21 levels and liver steatosis are associated with parenteral nutrition duration and extent of small intestinal resection.
  • Serum FGF21 may serve as a useful non-invasive biomarker for diagnosing liver steatosis in pediatric IF patients.
Abstract

Keywords:
ALTAPRIASTAST-to-platelet ratio indexBMIChildrenFGF21GTGlucose homeostasisHDLHOMA-IRHbA1cIFIFALDINRISO-BMIIntestinal failureLDLLiver steatosisNASHP-TTPNSerum lipidsalanine aminotransferaseaspartate aminotransferasebody mass indexbody mass index-for-agefibroblast growth factor 21glutamyl transferaseglycosylated hemoglobinhigh-density lipoproteinhomeostasis model assessmentinternational normalized ratiointestinal failureintestinal failure associated liver diseaselow-density lipoproteinnonalcoholic steatohepatitisparenteral nutritionplasma tromboplastin time

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