Published online Nov 28, 2016. doi: 10.3748/wjg.v22.i44.9844
Peer-review started: July 22, 2016
First decision: August 22, 2016
Revised: August 29, 2016
Accepted: September 14, 2016
Article in press: September 14, 2016
Published online: November 28, 2016
Processing time: 128 Days and 3.8 Hours
To assess disease-specific circulating microRNAs (miRNAs) in non-alcoholic steatohepatitis (NASH) patients.
A total of 111 biopsy-proven non-alcoholic fatty liver disease (NAFLD) or chronic hepatitis B (CHB) patients and healthy controls from mainland China were enrolled to measure their serum levels of miR-122, -125b, -146b, -16, -21, -192, -27b and -34a. The correlations between serum miRNAs and histological features of NAFLD were determined. The diagnostic value of miRNA in NASH and significant fibrosis was analyzed and compared with that of cytokeratin-18 (CK-18), fibrosis-4 (FIB-4), and aspartate aminotransferase to platelet ratio index (APRI), respectively.
Circulating miR-122, -16, -192 and -34a showed differential expression levels between NAFLD and CHB patients, and miR-34a had an approximately 2-fold increase in NAFLD samples compared with that of CHB samples (P < 0.01). Serum miR-122, -192 and -34a levels were correlated with steatosis (R = 0.302, 0.323 and 0.470, respectively, P < 0.05) and inflammatory activity (R = 0.445, 0.447 and 0.517, respectively, P < 0.01); only serum miR-16 levels were associated with fibrosis (R = 0.350, P < 0.05) in patients with NAFLD. The diagnostic value of miR-34a for NASH (area under the receiver operating characteristic, 0.811, 95%CI: 0.670-0.953) was superior to that of alanine aminotransferase, CK-18, FIB-4 and APRI in NAFLD, but miR-16 showed a limited performance in the diagnosis of significant fibrosis in NASH.
Circulating miR-34a may serve as a disease-specific noninvasive biomarker for the diagnosis of NASH.
Core tip: Circulating miR-122, -192, -34a and -16 showed differential expression levels between non-alcoholic fatty liver disease and chronic hepatitis B patients, and serum miR-122, -192 and -34a could also differentiate non-alcoholic steatohepatitis (NASH) from non-alcoholic fatty liver. The latter were correlated with steatosis and inflammatory activity, and only serum miR-16 was associated with hepatic fibrosis. The diagnostic value of miR-34a for NASH was superior to that of alanine aminotransferase and cytokeratin-18, but miR-16 showed a slightly poorer performance than that of fibrosis-4 and aspartate aminotransferase to platelet ratio index in the diagnosis of significant fibrosis in NASH.