Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China.
Nat Rev Gastroenterol Hepatol. 2018 Aug;15(8):461-478. doi: 10.1038/s41575-018-0014-9.
Nonalcoholic fatty liver disease (NAFLD) affects 25% of the global adult population and is the most common chronic liver disease worldwide. Nonalcoholic steatohepatitis (NASH) is the active form of NAFLD, with hepatic necroinflammation and faster fibrosis progression. With an increasing number of patients developing NASH-related end-stage liver disease and pharmacological treatments on the horizon, there is a pressing need to develop NAFLD and NASH biomarkers for prognostication, selection of patients for treatment and monitoring. This requirement is particularly true as liver biopsy utility is limited by its invasive nature, poor patient acceptability and sampling variability. This article reviews current and potential biomarkers for different features of NAFLD, namely, steatosis, necroinflammation and fibrosis. For each biomarker, we evaluate its accuracy, reproducibility, responsiveness, feasibility and limitations. We cover biochemical, imaging and genetic biomarkers and discuss biomarker discovery in the omics era.
非酒精性脂肪性肝病（NAFLD）影响全球成年人口的 25%，是全球最常见的慢性肝病。非酒精性脂肪性肝炎（NASH）是 NAFLD 的活动形式，具有肝脏坏死性炎症和更快的纤维化进展。随着越来越多的患者发展为 NASH 相关终末期肝病和新的治疗药物出现，迫切需要开发用于预后、治疗选择和监测的 NAFLD 和 NASH 生物标志物。由于肝活检的侵入性、较差的患者可接受性和取样变异性，其应用受到限制，因此这种需求尤其真实。本文综述了用于 NAFLD 不同特征（即脂肪变性、坏死性炎症和纤维化）的现有和潜在生物标志物。对于每个生物标志物，我们评估其准确性、可重复性、响应性、可行性和局限性。我们涵盖了生化、影像学和遗传学标志物，并讨论了组学时代的生物标志物发现。
