EP377 - ECE_3691 - FABP4 and fatty liver index in obesity: insights across metabolic health categories
TL;DR
The findings support FABP4 as a potential biomarker reflecting both metabolic phenotype and liver steatosis in obesity and further studies are needed to clarify the role of FABP4 as a non-invasive indicator of NAFDL.
Abstract
Fatty Acid Binding Protein 4 (FABP4) is an intracellular lipid-binding protein involved in the regulation of fatty acid transport, lipid signalling, and cholesterol homeostasis. Elevated circulating FABP4 levels have been proposed as a potential biomarker for the detection and progression of liver steatosis. It represents the initial stage of non-alcoholic fatty liver disease (NAFDL), a condition strongly linked to metabolic dysregulation. Moreover, metabolic syndrome (MetS) is frequently associated with the development and severity of liver steatosis. The goal of this study is to examine the association of FAB4 with liver steatosis in metabolic healthy obese (MHO), pre-metabolic syndrome(pre—MetS) and metabolic syndrome (MetS) patient. We conducted a cross-sectional study including 103 treatment-naive obese patients (body mass index, BMI ≥ 30 kg/m2). Participants were divided into three groups: MHO (n = 18), who did not meet any MetS criteria and were not using antihypertensive, glucose-lowering, or lipid-lowering medications; pre-MetS (n = 32), who met at least one MetS criterion (excluding waist circumference), but did not fulfil the full MetS definition; and MetS (n = 53). Multiple biochemical parameters were analysed. BMI and waist circumference (WC) were assessed. The fatty liver index (FLI) was calculated using a validated logistic regression formula. An FLI ≥ 60 was considered indicative of a high risk of liver steatosis. FABP4 levels differed significantly between the three groups (P < .001). Further analysis showed lower FABP4 in the MHO group compared with both METS (P = .001) and pre-METs (P = .032), while MetS and pre-METs did not differ (P = .354). FLI also differed significantly between groups (P < .001), with all pairwise comparisons showing significance. FLI was higher in the MetS group than in the other groups, and higher in the pre-MetS group than in the MHO group. FABP4 correlated with FLI (r = 0.430), GGTP (r = 0.264) and ALT (r = 0.212). In binary logistic regression, FABP4 was positively associated with liver steatosis (FLI ≥ 60) in both crude (P < .001; OR 42.530 95% Cl 6.12-295.58) and adjusted models (P < .001; OR 1.22, 95% CI 1.078-1.378). FABP4 levels were higher in patients with FLI ≥ 60 than in those with FLI < 60 (P < .001). Overall, our findings support FABP4 as a potential biomarker reflecting both metabolic phenotype and liver steatosis in obesity. Further studies are needed to clarify the role of FABP4 as a non-invasive indicator of NAFDL.