RT Journal Article T1 Mistranslation Drives Alterations in Protein Levels and the Effects of a Synonymous Variant at the Fibroblast Growth Factor 21 Locus. A1 Bayoumi, Ali A1 Elsayed, Asmaa A1 Han, Shuanglin A1 Petta, Salvatore A1 Adams, Leon A A1 Aller, Rocio A1 Khan, Anis A1 García-Monzón, Carmelo A1 Arias-Loste, María Teresa A1 Miele, Luca A1 Latchoumanin, Olivier A1 Alenizi, Shafi A1 Gallego-Durán, Rocio A1 Fischer, Janett A1 Berg, Thomas A1 Craxì, Antonio A1 Metwally, Mayada A1 Qiao, Liang A1 Liddle, Christopher A1 Yki-Järvinen, Hannele A1 Bugianesi, Elisabetta A1 Romero-Gomez, Manuel A1 George, Jacob A1 Eslam, Mohammed K1 fibroblast growth factor 21 K1 genetics K1 metabolic K1 metabolic associated fatty liver disease AB Fibroblast growth factor 21 (FGF21) is a liver-derived hormone with pleiotropic beneficial effects on metabolism. Paradoxically, FGF21 levels are elevated in metabolic diseases. Interventions that restore metabolic homeostasis reduce FGF21. Whether abnormalities in FGF21 secretion or resistance in peripheral tissues is the initiating factor in altering FGF21 levels and function in humans is unknown. A genetic approach is used to help resolve this paradox. The authors demonstrate that the primary event in dysmetabolic phenotypes is the elevation of FGF21 secretion. The latter is regulated by translational reprogramming in a genotype- and context-dependent manner. To relate the findings to tissues outcomes, the minor (A) allele of rs838133 is shown to be associated with increased hepatic inflammation in patients with metabolic associated fatty liver disease. The results here highlight a dominant role for translation of the FGF21 protein to explain variations in blood levels that is at least partially inherited. These results provide a framework for translational reprogramming of FGF21 to treat metabolic diseases. YR 2021 FD 2021-05-01 LK http://hdl.handle.net/10668/18013 UL http://hdl.handle.net/10668/18013 LA en DS RISalud RD Apr 7, 2025