Wojcik Malgorzata, Janus Dominika, Dolezal-Oltarzewska Katarzyna, Kalicka-Kasperczyk Anna, Poplawska Karolina, Drozdz Dorota, Sztefko Krystyna, Starzyk Jerzy B
Pediatric and Adolescent Endocrinology Department, Chair of Pediatrics, Jagiellonian University, Collegium Medicum, Wielicka 265 str. 30-663 Krakow, Poland.
J Pediatr Endocrinol Metab. 2012;25(11-12):1089-93. doi: 10.1515/jpem-2012-0253.
Fibroblast growth factor 19 (FGF19) is a hormone released from the small intestine; recently, it has emerged as an endocrine regulator of glucose and lipid metabolism. The aim of this study was to investigate the role of FGF19 in the development of nonalcoholic fatty liver disease (NAFLD).
This study included 23 (17 boys) obese adolescents (mean age of 14.1 years) with NAFLD. The control group consisted of 34 (13 boys) obese peers with normal ultrasonographic imaging and normal liver function tests.
The definition of NAFLD was based on clinical criteria: elevated alanine aminotransferase (>35 U/L) and liver steatosis features on ultrasound imaging. Serum FGF19 levels were measured in a fasting blood sample. The definition of insulin resistance was based on the homeostasis model assessment (HOMA) threshold: >2.5.
There was a significant difference between mean FGF19 levels in patients with NAFLD and controls (142.2 vs. 206 pg/mL, p=0.04). Mean fasting FGF19 levels were decreased in insulin-resistant patients in comparison with the non-insulin-resistant group (155.0 vs. 221.0 pg/mL, p=0.05). There was an inverse correlation between FGF19 and alanine aminotransferase levels (R=-0.3, p<0.05) and triglycerides (R=-0.27, p<0.05).
A decrease in fasting FGF19 is associated with the development of NAFLD in obese adolescents. A decrease in fasting FGF19 levels may be a new important risk factor for NAFLD and the metabolic syndrome in adolescents. Further studies are needed to explain whether exogenous delivery of FGF19 might be therapeutically beneficial.
成纤维细胞生长因子19（FGF19）是一种从小肠释放的激素；最近，它已成为葡萄糖和脂质代谢的内分泌调节因子。本研究的目的是探讨FGF19在非酒精性脂肪性肝病（NAFLD）发生发展中的作用。
本研究纳入了23名（17名男孩）患有NAFLD的肥胖青少年（平均年龄14.1岁）。对照组由34名（13名男孩）肥胖同龄人组成，其超声成像正常且肝功能检查正常。
NAFLD的定义基于临床标准：丙氨酸转氨酶升高（>35 U/L）以及超声成像显示肝脏脂肪变性特征。在空腹血样中测量血清FGF19水平。胰岛素抵抗的定义基于稳态模型评估（HOMA）阈值：>2.5。
NAFLD患者与对照组的平均FGF19水平存在显著差异（142.2对206 pg/mL，p = 0.04）。与非胰岛素抵抗组相比，胰岛素抵抗患者的平均空腹FGF19水平降低（155.0对221.0 pg/mL，p = 0.05）。FGF19与丙氨酸转氨酶水平（R = -0.3，p < 0.05）和甘油三酯（R = -0.27，p < 0.05）呈负相关。
空腹FGF19降低与肥胖青少年NAFLD的发生有关。空腹FGF19水平降低可能是青少年NAFLD和代谢综合征的一个新的重要危险因素。需要进一步研究来解释外源性给予FGF19是否具有治疗益处。
