Liang Huimin, Zhang Deyuan, Wei Na, Xi Pengjiao, Ge Haize, Zhang Yan
School of Nursing, Tianjin Medical University, Tianjin, China.
Department of Nursing, Beijing Sunshine Lu-Tong Hospital of Traditional Chinese Medicine, Beijing, China.
Front Endocrinol (Lausanne). 2025 Aug 28;16:1652996. doi: 10.3389/fendo.2025.1652996. eCollection 2025.
Non-alcoholic fatty liver disease (NAFLD) has become the most common chronic liver condition globally, spanning a spectrum from simple steatosis to non-alcoholic steatohepatitis (NASH) and progressive fibrosis. Inflammation and metabolic dysregulation play key roles in its pathogenesis. Accordingly, inflammatory and metabolic biomarkers have gained increasing attention as potential tools for non-invasive diagnosis and disease staging.
This scoping review aimed to synthesize current evidence on the diagnostic performance of inflammatory and metabolic biomarkers for NAFLD, with a focus on their potential application in early screening and disease stratification.
We systematically searched PubMed and CNKI databases for relevant peer-reviewed literature published up to August 2024. The search strategy combined MeSH terms and free-text keywords, and study selection was guided by the Population-Concept-Context (PCC) framework. Methodological quality was assessed using the Newcastle-Ottawa Scale and AHRQ criteria.
Fifteen eligible studies (11 case-control, 2 cohort, 1 cross-sectional, and 1 retrospective study) were included, yielding 18 candidate biomarkers. The triglyceride-glucose (TyG) index was commonly associated with early-stage NAFLD screening; cytokeratin-18 (CK18) was linked to NASH detection, while adiponectin and osteopontin (OPN) were related to liver fibrosis. Additionally, inflammatory indices such as neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and systemic immune-inflammation index (SII) showed clinical promise due to their accessibility and low cost.
Inflammatory and metabolic biomarkers provide valuable non-invasive insights into the diagnosis and staging of NAFLD. The integration of multiple biomarkers may enhance diagnostic accuracy and support stratified management strategies. However, further validation is needed to establish standardized thresholds and confirm clinical utility across diverse populations.
非酒精性脂肪性肝病（NAFLD）已成为全球最常见的慢性肝脏疾病，涵盖从单纯性脂肪变性到非酒精性脂肪性肝炎（NASH）和进行性纤维化的一系列病变。炎症和代谢失调在其发病机制中起关键作用。因此，炎症和代谢生物标志物作为非侵入性诊断和疾病分期的潜在工具受到了越来越多的关注。
本范围综述旨在综合目前关于炎症和代谢生物标志物对NAFLD诊断性能的证据，重点关注它们在早期筛查和疾病分层中的潜在应用。
我们系统检索了截至2024年8月发表的相关同行评审文献的PubMed和CNKI数据库。检索策略结合了医学主题词和自由文本关键词，研究选择以人群-概念-背景（PCC）框架为指导。使用纽卡斯尔-渥太华量表和AHRQ标准评估方法学质量。
纳入了15项符合条件的研究（11项病例对照研究、2项队列研究、1项横断面研究和1项回顾性研究），产生了18种候选生物标志物。甘油三酯-葡萄糖（TyG）指数通常与NAFLD早期筛查相关；细胞角蛋白-18（CK18）与NASH检测相关，而脂联素和骨桥蛋白（OPN）与肝纤维化相关。此外，中性粒细胞与淋巴细胞比率（NLR）、单核细胞与淋巴细胞比率（MLR）和全身免疫炎症指数（SII）等炎症指标因其易获取性和低成本而显示出临床应用前景。
炎症和代谢生物标志物为NAFLD的诊断和分期提供了有价值的非侵入性见解。多种生物标志物的整合可能提高诊断准确性并支持分层管理策略。然而，需要进一步验证以建立标准化阈值并确认在不同人群中的临床效用。
