Translational gastroenterology and hepatology · 2026
Exploratory analysis of serum FGF-21 and CK-18 as biomarkers for ultrasound-detected MASLD in type 2 diabetes mellitus: a UAE multicenter study.
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Alhaj Abeer, Mussa Bashair M, Bhamidimarri Poorna Manasa, Sulaiman Mohsin, Rashwan Dana Ahmed, Alfarahid Oraib, Wahbea Rasha Talieb, Adra Lana, Elbo-Iswadi Tabarak Haamid, Hafidh Khadija, Abusnana Salah
Аннотация
BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common chronic liver disease worldwide, particularly among individuals with type 2 diabetes mellitus (T2DM). This exploratory multicenter study evaluated the association and diagnostic performance of the serum biomarkers cytokeratin 18 fragment M30 (CK-18 M30) and fibroblast growth factor 21 (FGF-21) in T2DM patients with and without ultrasound-detected MASLD.
METHODS: A multicenter case-control observational study was conducted on a total of 125 T2DM patients in the United Arab Emirates (UAE). Two groups of T2DM patients, MASLD and non-MASLD, were recruited for investigation of different serum biomarkers. An overnight fasting blood sample was collected for investigation of two biomarkers, including CK-18 M30 and FGF-21.
RESULTS: The study included 125 participants (mean age 55.9±8.9 years; 52.8% female). A subset of 66 participants was analyzed for serum biomarkers (FGF-21 and CK-18). Overall, 50.4% were obese (body mass index >30 kg/m2), and 97% had elevated waist circumference. Uncontrolled glycated hemoglobin (HbA1c) was more frequent in MASLD patients (58.1%) than in non-MASLD patients (35.9%; P=0.02). In the MASLD group, FGF-21 levels were positively correlated with alanine transaminase levels (P=0.04) and negatively correlated with CK-18 levels (P=0.047). Median FGF-21 levels were significantly higher in the MASLD group versus the non-MASLD group (P=0.03).
CONCLUSIONS: Dyslipidemia and uncontrolled HbA1c were significantly associated with MASLD in T2DM patients. FGF-21 levels were higher in MASLD patients; however, its diagnostic performance was modest, and it was not independently associated with MASLD after multivariate adjustment.
METHODS: A multicenter case-control observational study was conducted on a total of 125 T2DM patients in the United Arab Emirates (UAE). Two groups of T2DM patients, MASLD and non-MASLD, were recruited for investigation of different serum biomarkers. An overnight fasting blood sample was collected for investigation of two biomarkers, including CK-18 M30 and FGF-21.
RESULTS: The study included 125 participants (mean age 55.9±8.9 years; 52.8% female). A subset of 66 participants was analyzed for serum biomarkers (FGF-21 and CK-18). Overall, 50.4% were obese (body mass index >30 kg/m2), and 97% had elevated waist circumference. Uncontrolled glycated hemoglobin (HbA1c) was more frequent in MASLD patients (58.1%) than in non-MASLD patients (35.9%; P=0.02). In the MASLD group, FGF-21 levels were positively correlated with alanine transaminase levels (P=0.04) and negatively correlated with CK-18 levels (P=0.047). Median FGF-21 levels were significantly higher in the MASLD group versus the non-MASLD group (P=0.03).
CONCLUSIONS: Dyslipidemia and uncontrolled HbA1c were significantly associated with MASLD in T2DM patients. FGF-21 levels were higher in MASLD patients; however, its diagnostic performance was modest, and it was not independently associated with MASLD after multivariate adjustment.