Ye Liu*, Fang Ji**, Da-Ang Hao*, Jun-Gui Hao**, Li-Ping Wang**, Ming-Jia Dai**, Jing-Qiao Wang***, Xue-Bing Yan*,**,*#


*Department of Infectious Disease, Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China - **Department of Infectious Disease, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China - ***Department of Medical Laboratory, Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China


Many noninvasive screening and diagnostic models have been developed to identify NAFLD. However, these models are not adequate to screen for NAFLD and lack of hormone substance. Fibroblast growth factor 21(FGF21) is a hormone peptide that regulates glucose and lipid metabolism and decreases liver fat accumulation and inflammatory response. The main aim of the study is to optimize existing models using FGF21 to diagnose NAFLD. Every participant underwent systematic evaluation and ultrasound examination. All potential variables were involved in the multivariable test and logistic regression analysis to construct a new NAFLD diagnostic model. Age, gender, body mass index, alanine aminotransferase, triglycerides, white blood cell count and FGF21 were used to construct the new diagnostic model, which was named NAFLD score associated with FGF21(NSAF).The model indicated good diagnostic value for NAFLD (AUROC = 0.878, 95% CI 0.857–0.899). The cut-off point was 0.336, the corresponding sensitivity was 82.3%, and the specificity was 79.5%. Serum FGF21 levels in the NAFLD group were significantly higher than in the non-NAFLD group. However, in NAFLD patients, serum FGF21 levels did not differ significantly between the obese and nonobese groups. Serum FGF21 levels in NAFLD and obese patients were increased. Obesity is not the main cause of the rise in FGF21 in NAFLD patients.


Nonalcoholic fatty liver disease, Noninvasive diagnostic model, Fibroblast growth factor 21, Obesity, Fibroblast growth factor 21 resistance.