Fibroblast Growth Factor-21 to Adiponectin Ratio: A Potential Biomarker to Monitor Liver Fat in Children With Obesity
Emir Tas, Shasha Bai, Xiawei Ou, Kelly E. Mercer, Haixia Lin, Kori Mansfield, Robert F. Buchmann, Eva C. Diaz, Jon D. Oden, Elisabet Børsheim, Sean H. Adams, Jonathan A. Dranoff
Abstract
Background. There is a pressing need for effective and non-invasive biomarkers to track intrahepatic triglyceride (IHTG) in children at-risk for non-alcoholic fatty liver disease (NAFLD), as standard-of-care reference tools, liver biopsy and magnetic resonance imaging (MRI), are impractical to monitor the course disease. Objective. We aimed to examine the association between serum fibroblast growth factor (FGF)-21 to adiponectin ratio (FAR) and IHTG as assessed by MRI in children with obesity. Methods. Serum FGF21 and adiponectin levels and IHTG were measured at two-time points (baseline, 6 months) in obese children enrolled in a clinical weight loss program. The association between percent change in FAR and IHTG at the final visit was examined using a multiple linear regression model. Results. At baseline, FAR was higher in the subjects with NAFLD (n=23, 35.8 ± 41.9 pg/ng) than without NAFLD (n=35, 19.8 ± 13.7 pg/ng; p=0.042). Forty-eight subjects completed both visits and were divided into IHTG loss (≥1% reduction than baseline), no change (within 1% change), and gain (≥1% increase than baseline) groups. At 6 months, the percent change in FAR was different among the three groups (p=0.005). Multiple linear regression showed a positive relationship between percent change in FAR and the final liver fat percent in sex and pubertal stage-similar subjects with NAFLD at baseline (slope coefficient 6.18, 95% CI 1.90 to 10.47, P=0.007), but not in those without NAFLD. Conclusions. Higher value in percent increase in FAR is positively associated with a higher level of IHTG percent value at 6 months in children with baseline NAFLD. FAR could be a potential biomarker to monitor the changes in IHTG in children with NAFLD.