Aims

/Introduction

Metabolic dysfunction-associated fatty liver disease (MAFLD), defined as hepatosteatosis with type 2 diabetes mellitus, overweight/obesity or metabolic dysregulation, has been proposed as a new feature of chronic liver disease. Fatty acid-binding protein 4 (FABP4) is expressed in adipose tissue, and secreted FABP4 is associated with the development of insulin resistance and atherosclerosis. However, the relationship between MAFLD and FABP4 has not been fully addressed.

Materials and Methods

Associations of MAFLD with metabolic markers including FABP4, fibroblast growth factor 21 (FGF21) and adiponectin were investigated in 627 subjects (men/women: 292/335) in the Tanno-Sobetsu Study, a population-based cohort.

Results

The mean age was 65 years (range: 19~98 years, median [interquartile range]: 68 [56-76] years). Hepatosteatosis was determined by fatty liver index (FLI), and FLI≥35 for men and FLI≥16 for women were used for detection of fatty liver as previously reported using 14,471 Japanese subjects. FLI was positively correlated with systolic blood pressure (SBP) and levels of FABP4 (r=0.331, P<0.001), FGF21, HOMA-R as an insulin resistance index and urate and was negatively correlated with levels of high-density lipoprotein cholesterol (HDL-C) and adiponectin. FABP4 concentration was independently associated with FLI after adjustment of age, sex, SBP and levels of urate, HDL-C, HOMA-R, adiponectin and FGF21 in multivariable regression analysis. Logistic regression analysis showed that FABP4 was an independent predictor of MAFLD after adjustment of age, sex, presence of diabetes mellitus, hypertension and dyslipidemia, and levels of urate, HOMA-R, adiponectin and FGF21.

Conclusions

FABP4 concentration is independently associated with FLI and is an independent predictor of MAFLD in middle-aged and elderly individuals.