Dynamic Alterations of BMP9 in NAFLD: A Novel Hepatokine Marker of Metabolic Dysfunction and Disease Severity

Fan Cui,1,2,* Fangmin Chen,3,* Fanchao Dong,4,* Jianjun Dong1 1Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong, People’s Republic of China; 2Department of Endocrinology, Linyi Traditional Chinese Medicine Hospital, Linyi, Shandong, People’s Republic of China; 3Department of Rehabilitation, Linyi Traditional Chinese Medicine Hospital, Linyi, Shandong, People’s Republic of China; 4Department of Nursing, Linyi Cancer Hospital, Linyi, Shandong, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jianjun Dong, Department of Endocrinology, Qilu Hospital of Shandong University, No. 107 Wenhuaxi Road, Lixia District, Jinan, Shandong, 250012, People’s Republic of China, Email [email protected]: Bone morphogenetic protein 9 (BMP9), a hepatokine belonging to the transforming growth factor-β (TGF-β) superfamily, plays a critical role in glucose and lipid metabolism. This study aimed to investigate the dynamic changes of BMP9 under metabolic stress in patients with different severities of non-alcoholic fatty liver disease (NAFLD), and to evaluate its associations with metabolic abnormalities and clinical diagnostic value.Patients and Methods: A total of 84 participants were enrolled and categorized into normal control (Con), mild, moderate, and severe NAFLD groups. Standardized oral fat tolerance tests (OFTT) were conducted to assess dynamic alterations in circulating BMP9 and related metabolic indices. Trend analysis, Spearman correlation, multivariate regression, and receiver operating characteristic (ROC) curve analyses were performed to explore the relationships between BMP9 and metabolic parameters as well as its diagnostic performance.Results: Both fasting and postprandial BMP9 levels declined with increasing NAFLD severity, with a more pronounced reduction observed in the severe group (P