Department of Clinical and Experimental Medicine, Internal Medicine, Garibaldi-Nesima Hospital, University of Catania, 95122 Catania, Italy.
Faculty of Medicine and Surgery, "Kore" University of Enna, 94100 Enna, Italy.
Int J Mol Sci. 2021 Nov 2;22(21):11905. doi: 10.3390/ijms222111905.
Non-alcoholic fatty liver disease (NAFLD) is the most common hepatic pathology in industrialized countries, affecting about 25% of the general population. NAFLD is a benign condition, however, it could evolve toward more serious diseases, including non-alcoholic steatohepatitis (NASH), fibrosis, cirrhosis, and finally, hepatocellular carcinoma (HCC). Liver biopsy is still the gold standard for NAFLD diagnosis. Due to the risks associated with liver biopsy and the impossibility to apply it on a large scale, it is now necessary to identify non-invasive biomarkers, which may reliably identify patients at higher risk of progression. Therefore, several lines of research have tried to address this issue by identifying novel biomarkers using omics approaches, including lipidomics, metabolomics and RNA molecules' profiling. Thus, in this review, we firstly report the conventional biomarkers used in clinical practice for NAFL and NASH diagnosis as well as fibrosis staging, and secondly, we pay attention to novel biomarkers discovered through omics approaches with a particular focus on RNA biomarkers (microRNAs, long-noncoding RNAs), showing promising diagnostic performance for NAFL/NASH diagnosis and fibrosis staging.
非酒精性脂肪性肝病 (NAFLD) 是工业化国家最常见的肝脏病理学，影响约 25%的普通人群。NAFLD 是一种良性疾病，但它可能会向更严重的疾病发展，包括非酒精性脂肪性肝炎 (NASH)、纤维化、肝硬化，最终发展为肝细胞癌 (HCC)。肝活检仍然是 NAFLD 诊断的金标准。由于肝活检存在风险，且不可能大规模应用，因此现在需要确定非侵入性生物标志物，以便可靠地识别进展风险较高的患者。因此，一些研究已经尝试通过使用组学方法（包括脂质组学、代谢组学和 RNA 分子谱）来确定新的生物标志物来解决这个问题。因此，在这篇综述中，我们首先报告了临床实践中用于诊断 NAFL 和 NASH 以及纤维化分期的常规生物标志物，其次，我们关注了通过组学方法发现的新型生物标志物，特别关注 RNA 生物标志物（microRNAs、长非编码 RNA），它们在 NAFL/NASH 诊断和纤维化分期方面表现出有希望的诊断性能。
