Role of Serum FGF21 in the diagnosis of Metabolic dysfunction–Associated Fatty Liver Disease: A Case-Control Study of Egyptian patients

Role of Serum FGF21 in the diagnosis of Metabolic dysfunction–Associated Fatty Liver Disease: A Case-Control Study of Egyptian patients | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Role of Serum FGF21 in the diagnosis of Metabolic dysfunction–Associated Fatty Liver Disease: A Case-Control Study of Egyptian patients Zeinab M. Nabil, Basant Elmarashly This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7441456/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 09 Dec, 2025 Read the published version in Egyptian Liver Journal → Version 1 posted You are reading this latest preprint version Abstract Background Metabolic dysfunction-associated fatty liver disease (MAFLD) is one of the most common etiologies of hepatic dysfunction worldwide. Fibroblast growth factor 21 (FGF21), a hepatokine involved in lipid metabolism and insulin sensitivity, may serve as a promising biomarker for MAFLD diagnosis and staging. Our study aimed to weigh the value of FGF21 as a sensitive and accurate biomarker of MAFLD. Methods This case-control study involved 80 adults, comprising 40 patients with MAFLD and 40 healthy controls, recruited from Ain Shams University Hospital. All participants had clinical, laboratory, and imaging assessments. Serum FGF21 assay was done using ELISA, and hepatic steatosis and fibrosis were evaluated using ultrasonography, noninvasive scoring methods (FLI, NFS, and FIB-4), and transient elastography. Results Serum FGF21 concentrations were markedly increased in MAFLD patients relative to controls (p < 0.001). FGF21 exhibited a positive correlation with BMI, waist circumference, insulin resistance, dyslipidemia, liver enzymes, GGT, steatosis, and fibrosis scores. Elevated FGF21 levels were correlated with more advanced stages of steatosis and fibrosis. ROC curve analysis demonstrated excellent diagnostic performance of FGF21 for MAFLD (AUC = 0.964), exhibiting 80% specificity and 97.5% sensitivity at a threshold of 120.32 pg/mL. Conclusion FGF21 is strongly correlated with the severity of MAFLD, making it a potentially useful biological biomarker for diagnosis and disease stratification. Additional comprehensive studies are necessary to confirm its diagnostic and therapeutic efficacy. FGF21 MAFLD NAFLD Metabolic Syndrome Insulin Resistance Obesity Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 09 Dec, 2025 Read the published version in Egyptian Liver Journal → Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7441456","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":506709404,"identity":"3a463649-f602-47be-b8eb-4d85b5840c80","order_by":0,"name":"Zeinab M. 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Fibroblast growth factor 21 (FGF21), a hepatokine involved in lipid metabolism and insulin sensitivity, may serve as a promising biomarker for MAFLD diagnosis and staging. Our study aimed to weigh the value of FGF21 as a sensitive and accurate biomarker of MAFLD.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eThis case-control study involved 80 adults, comprising 40 patients with MAFLD and 40 healthy controls, recruited from Ain Shams University Hospital. All participants had clinical, laboratory, and imaging assessments. Serum FGF21 assay was done using ELISA, and hepatic steatosis and fibrosis were evaluated using ultrasonography, noninvasive scoring methods (FLI, NFS, and FIB-4), and transient elastography.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eSerum FGF21 concentrations were markedly increased in MAFLD patients relative to controls (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). FGF21 exhibited a positive correlation with BMI, waist circumference, insulin resistance, dyslipidemia, liver enzymes, GGT, steatosis, and fibrosis scores. Elevated FGF21 levels were correlated with more advanced stages of steatosis and fibrosis. ROC curve analysis demonstrated excellent diagnostic performance of FGF21 for MAFLD (AUC\u0026thinsp;=\u0026thinsp;0.964), exhibiting 80% specificity and 97.5% sensitivity at a threshold of 120.32 pg/mL.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eFGF21 is strongly correlated with the severity of MAFLD, making it a potentially useful biological biomarker for diagnosis and disease stratification. Additional comprehensive studies are necessary to confirm its diagnostic and therapeutic efficacy.\u003c/p\u003e","manuscriptTitle":"Role of Serum FGF21 in the diagnosis of Metabolic dysfunction–Associated Fatty Liver Disease: A Case-Control Study of Egyptian patients","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-04 20:06:12","doi":"10.21203/rs.3.rs-7441456/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b920876d-b8fa-40b2-9c22-4ed1626b8e16","owner":[],"postedDate":"September 4th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-12-15T15:59:51+00:00","versionOfRecord":{"articleIdentity":"rs-7441456","link":"https://doi.org/10.1186/s43066-025-00477-1","journal":{"identity":"egyptian-liver-journal","isVorOnly":false,"title":"Egyptian Liver Journal"},"publishedOn":"2025-12-09 15:56:55","publishedOnDateReadable":"December 9th, 2025"},"versionCreatedAt":"2025-09-04 20:06:12","video":"","vorDoi":"10.1186/s43066-025-00477-1","vorDoiUrl":"https://doi.org/10.1186/s43066-025-00477-1","workflowStages":[]},"version":"v1","identity":"rs-7441456","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7441456","identity":"rs-7441456","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}