Objective  To investigate the correlation between plasma fibroblast growth factor 21 (FGF21) level

obesity and insulin resistance (IR) in nonalcoholic fatty liver disease (NAFLD) patients.   Methods  Seventy NAFLD patients were divided into fatty liver (FL) group (n=36)

type 2 diabetes complicated by fatty liver (DFL) group (n=34 cases)

and normal control (NC) group (n=26) according to their complication of type 2 diabetics. Levels of plasma FGF21

fasting plasma glucose (FPG)

fasting insulin (FINS)

free fatty acid (FFA)

lipid

body mass index (BMI) and waist-to-hip ratio (WHR) were measured by enzyme-linked immunosorbent assay. Insulin resistance was evaluated using the steady-state model HOMA-IR and insulin sensitivity index (ISI).   Results  The levels of obesity

BMI

WHR

triglyceride (TG)

total cholesterol (TC)

low-density lipoprotein cholesterol (LDL-C)

and FFA were significantly higher in FL and type 2 DFL groups than in NC group（P0.05

P0.01）. The high-density lipoprotein cholesterol (HDL-C) level was lower in FL and type 2 DFL groups than in NC group（P0.05）. The HAMO-IR was significantly higher and ISI was notably lower in type 2 DFL group than in NC group（P0.01

0.05）. The plasma FGF21 level was significantly higher in FL and type 2 DFL groups (1.86±0.64) ng/ml and (1.97±0.60) ng/ml than in NC group (1.26±0.43) ng/ml (P0.05). Correlation analysis showed that the plasma FGF21 level was positively correlated with BMI

WHR

HOMA-IR

TG

and FFA（r=0.278

0.335

0.326

0.312

and 0.307）

respectively (P0.05 or P0.01）

and negatively correlated with HDL and ISI（r=－0.255，－0.279）

respectively (P0.05）. Multiple stepwise regression analysis indicated that WHR

HOMAIR and TG were the independently relevant factors for serum FGF21 level.   Conclusion  Elevated plasma FGF21 level in NAFLD patients is closely related with obesity

insulin resistance and lipid metabolism disorder

and may play a role in the occurrence and development of FL.