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@ARTICLE{Franck:277921,
      author       = {M. Franck and K. John and S. Al Aoua and M. Rau and A.
                      Geier and J. M. Schattenberg and H. Wedemeyer and K. Schulze
                      Osthoff$^*$ and H. Bantel},
      title        = {{H}epatokine-based identification of fibrotic {NASH} and
                      improved risk stratification in a multicentre cohort of
                      {NAFLD} patients.},
      journal      = {Liver international},
      volume       = {43},
      number       = {12},
      issn         = {1478-3223},
      address      = {Oxford},
      publisher    = {Wiley-Blackwell},
      reportid     = {DKFZ-2023-01577},
      pages        = {2668-2679},
      year         = {2023},
      note         = {2023 Dec;43(12):2668-2679},
      abstract     = {The presence of significant liver fibrosis associated with
                      non-alcoholic steatohepatitis (NASH) is regarded as the
                      major prognostic factor in non-alcoholic fatty liver disease
                      (NAFLD). Identification of patients at risk for NASH with
                      significant fibrosis is therefore important. Although the
                      established fibrosis score FIB-4 is suitable to exclude
                      advanced fibrosis, it does not allow the prediction of
                      significant fibrosis in NAFLD patients. We therefore
                      evaluated whether the hepatokine fibroblast growth factor 21
                      (FGF21), a regulator of glucose and lipid metabolism, might
                      identify 'at-risk NASH' in NAFLD.FGF21 levels were assessed
                      by enzyme-linked immunosorbent assay in sera from an
                      exploration (n = 137) and a validation (n = 88) cohort of
                      biopsy-proven NAFLD patients with different disease activity
                      and fibrosis stages. In addition, we evaluated whether the
                      use of FGF21 could improve risk stratification in NAFLD
                      patients with low (<1.3) or intermediate (1.3-2.67)
                      FIB-4.FGF21 levels could significantly discriminate between
                      NASH and non-alcoholic fatty liver (NAFL) patients, even in
                      the absence of diabetes. Moreover, patients with NASH and
                      fibrosis ≥F2 showed significantly higher FGF21 levels
                      compared to NAFLD patients without significant fibrosis.
                      Significantly elevated FGF21 levels could even be detected
                      in NAFLD patients with NASH and significant fibrosis despite
                      low or intermediate FIB-4.Serological FGF21 detection might
                      allow the identification of NAFLD patients at risk and
                      improves patient stratification in combination with FIB-4.},
      keywords     = {FGF21 (Other) / FIB-4 (Other) / NAFLD (Other) / NASH
                      (Other) / fibrosis (Other) / hepatokine (Other)},
      cin          = {TU01},
      ddc          = {610},
      cid          = {I:(DE-He78)TU01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:37534777},
      doi          = {10.1111/liv.15686},
      url          = {https://inrepo02.dkfz.de/record/277921},
}