Background: Fibroblast growth factor (FGF)-21, a hormone predominantly secreted by the liver, has recently been reported as a key circulating adipokine involving in metabolic disorders and liver diseases. Previous studies have shown that increased FGF21 secretion may be a metabolic adaptation to starvation, fasting, ketogenic diet and protein restriction. This study was performed to investigate whether serum FGF21 level was also associated with the biliary atresia(BA).

Methods&Results: Serum FGF21 was measured in 35 BA patients (age, range 3-48 months) and 20(age, range 2-48 months)age matched healthy controls. Subjects with BA showed significantly higher serum FGF21 than those without BA (627 pg/mL (83-2300) vs.156pg/mL (77-354), P< 0.05). Besides serum concentrations, the mRNA and protein expression of FGF21 in the liver tissue was also quantified by real-time PCR and westernblot respectively, in 15 BA patients and 4 controls ( DCD liver without liver disease). In human liver tissues, FGF21 protein levels in patients with BA were significantly higher than those in control subjects. FGF21 mRNA expression increased with the degree of fibrosis (Scheuer fibrosis stage). Both serum FGF21 levels and mRNA expression were positively correlated with albumin and INR. Moreover, FGF-21 serum levels significantly decreased in BA patients within 6 months post liver transplantation approaching levels found in control subjects. (134 (64-328) vs.156pg/mL (77-354), P> 0.05).

Conclusion:We firstly demonstrated that FGF-21 levels in serum and liver tissue increased significantly in BA patients. FGF21 correlates with severity of patient's condition and may be a novel biomarker and therapeutic target for BA.

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