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Fibroblast growth factor 21 is independently associated with severe hepatic steatosis in non‐obese HIV‐infected patients
Author(s) -
Praktiknjo Michael,
Djayadi Natalie,
Mohr Raphael,
Schierwagen Robert,
Bischoff Jenny,
Dold Leona,
Pohlmann Alessandra,
SchwarzeZander Carolynne,
Wasmuth JanChristian,
Boesecke Christoph,
Rockstroh Jürgen K.,
Trebicka Jonel
Publication year - 2019
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.14107
Subject(s) - steatosis , medicine , gastroenterology , univariate analysis , fatty liver , risk factor , metabolic syndrome , obesity , multivariate analysis , disease
Background Severe hepatic steatosis shows a high prevalence and contributes to morbidity and mortality in human immunodeficiency virus (HIV) infected patients. Known risk factors include obesity, dyslipidaemia and features of metabolic syndrome. Fibroblast growth factor 21 (FGF‐21) is involved with hepatic glucose and lipid metabolism. This study aimed to evaluate FGF‐21 as a biomarker for severe hepatic steatosis in non‐obese HIV‐infected patients. Methods This is a prospective, cross‐sectional, monocentric study including HIV‐infected out‐patients. Hepatic steatosis was measured via controlled attenuation parameter (CAP) using FibroScan 502 touch (ECHOSENS, France). Severe hepatic steatosis was defined at CAP ≥ 253 dB/m. Peripheral blood samples were collected and plasma was analysed for FGF‐21. Demographic and clinical characteristics were collected from patient's health records. Results In total, 73 non‐obese HIV‐monoinfected patients were included in this study. Prevalence of severe hepatic steatosis was 41%. Patients with severe hepatic steatosis showed significantly higher levels of FGF‐21. Univariate analysis revealed FGF‐21, BMI, hyperlipidaemia, ALT levels and arterial hypertension as significant, while multivariate analysis showed only FGF‐21, arterial hypertension and ALT levels as significant independent risk factors for severe hepatic steatosis. Conclusion This study presents FGF‐21 as an independent and stronger predictor of severe hepatic steatosis than blood lipids in HIV‐infected patients. Moreover, arterial hypertension and ALT levels predict severe steatosis even in non‐obese HIV‐monoinfected patients. Furthermore, this study supports existing metabolic risk factors and expands them to non‐obese HIV‐infected patients.