Liver Fat Is Associated With Elevated FGF21 in Youth With Obesity but Without MASLD
Authors' conclusion
Among pubertal youth with obesity and liver fat below the MASLD threshold, modest increases in PDFF were independently associated with higher FGF21. These findings support the potential utility of FGF21 as a biomarker of early hepatic-metabolic stress in the framework of 'pre-MASLD' state-similar to pre-diabetes before the development of overt steatosis.
Study context
- Population
- Pubertal adolescents with obesity and liver fat <5% by MRI-PDFF; 62% female; mean age 14.7 ± 1.7 years
- Participants
- 58 adolescents
- Primary endpoint
- Association between liver fat (PDFF) <5% and metabolic markers, focus on FGF21
Primary result
As reported in the abstract
PDFF and FGF21 (adjusted for age, sex, race, ethnicity, BMI SDS)
Beta for FGF21 per 1% increase in PDFF; p = 0.02; persisted after log transformation
52 pg/mL
Further findings
PDFF
- Median PDFF
- 2.68%
Spearman correlations with PDFF
- PDFF correlated positively with BMI SDS, waist circumference, glucose, TG/HDL-C and FGF21
- No associations with homeostatic model assessment of insulin resistance (HOMA-IR), leptin or adiponectin
Original publication
Liver Fat Is Associated With Elevated FGF21 in Youth With Obesity but Without MASLD. Pediatr Obes. Published 10 February 2026. doi:10.
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