Serum FGF21 and RBP4 levels in patients with chronic hepatitis C.
BACKGROUND
Fibroblast growth factor-21 (FGF21) regulates glucose, lipid, and energy homeostasis. Retinol-binding protein-4 (RBP4) controls metabolic and proliferative cell functions.


OBJECTIVE
Aims of the study were to assess (1) serum FGF21 and RBP4 levels in 75 non-obese chronic hepatitis C (CHC) patients and 41 healthy controls similar in age and BMI; (2) the relationship between their serum concentration and insulin resistance, liver histology, and biochemical parameters; (3) their effectiveness as diagnostic markers.


RESULTS
FGF21 levels increased significantly in CHC patients compared with controls (p = 0.04). CHC patients with steatosis had significantly higher FGF21 levels compared with those without steatosis (p = 0.01). FGF21 concentration was positively related to steatosis grade (r = 0.39, p = 0.007). RBP4 levels did not differ between CHC patients and controls, but were negatively associated with necro-inflammatory activity grade (r = (-0.34), p = 0.04), with significantly higher levels in patients with minimal inflammatory activity (G1 vs. G2/3, p < 0.001; G1 vs. G2, p = 0 < 001; G1 vs. G3, p = 0.01). After stepwise linear regression analysis adjusting for potential confounders, RBP4 levels retained their independent significance as a predictor of necro-inflammatory activity (β = -0.31; t = -2.15, p = 0.035) and FGF21 levels as a predictor of steatosis (β = 0.34; t = 2.31, p = 0.024). Serum FGF21 correlated with serum RBP4 levels (r = 0.32, p = 0.02).


CONCLUSIONS
Serum FGF21 levels increased in CHC patients, especially in those with steatosis and were associated with steatosis grade. FGF21 seems to be a useful diagnostic marker in determining hepatic steatosis in CHC. A negative association between serum RBP4 and necro-inflammatory activity indicates that disease severity may determine RBP4 levels.
Department of Physiology in Zabrze, Medical University of Silesia, Katowice, Poland. kuklamich@poczta.onet.pl
Michał
M
Kukla
Agnieszka
A
Berdowska
Dominika
D
Stygar
Andrzej
A
Gabriel
Włodzimierz
W
Mazur
Beata
B
Łogiewa-Bazger
Barbara
B
Sobala-Szczygieł
Rafał J
RJ
Bułdak
Maria
M
Rokitka
Wojciech
W
Zajęcki
Lucjan
L
Kępa
Tomasz
T
Sawczyn
Krystyna
K
Zwirska-Korczala
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D016022:Case-Control Studies; D005234:Fatty Liver / Q000097:blood* / Q000150:complications / Q000473:pathology*; D005260:Female; D005346:Fibroblast Growth Factors / Q000097:blood*; D019698:Hepatitis C, Chronic / Q000097:blood* / Q000150:complications / Q000473:pathology*; D006801:Humans; D007333:Insulin Resistance; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D054839:Retinol-Binding Proteins, Plasma / Q000378:metabolism*; D018709:Statistics, Nonparametric
D015415:Biomarkers; C101326:RBP4 protein, human; D054839:Retinol-Binding Proteins, Plasma; C414620:fibroblast growth factor 21; D005346:Fibroblast Growth Factors; D000410:Alanine Transaminase