Abstract

Non-Alcoholic Fatty Liver Disease (NAFLD) covers a wide spectrum of disease, ranging from simple steatosis to cirrhosis. Liver biopsy is still the gold standard for assessing fibrosis, but there is a need to seek non-invasive biomarkers that can also be efficient in predicting fibrosis. To evaluate the role of microRNAs miR-21, miR-29a, miR-122, miR-155 and miR-181a in the phenotypic expression of NAFLD, correlating their serum levels with the different stages of the disease. Cross-sectional study carried out on 108 NAFLD patients diagnosed by liver biopsy. In the histological analysis, the degrees of fibrosis and NAFLD activity score (NAS) were obtained. The FIB-4 and NAFLD fibrosis score were calculated and compared with the degree of fibrosis by biopsy. The comparison between the distributions of microRNA values ​​according to the presence or absence of clinically expressed fibrosis (F2-4) was performed. The serum expression of microRNAs was also compared with the NAS of the biopsy. A multivariate logistic regression analysis was performed to build a score for predicting fibrosis using FIB-4 and Ln (miR-181a) as independent variables. Among the microRNAs studied, only miR-181a showed a statistical difference between patients with clinically expressed fibrosis and those without fibrosis (F0-F1) determined by liver biopsy (p = 0.017). FIB-4 revealed an AUC on the ROC curve of 0.667 to predict clinically expressed fibrosis (F2-F4). When assessed using the score in association with Ln (miR-181a), there was an improvement in the ROC curve, with AUC of 0.71. There was no correlation between the serum levels of microRNAs miR-21, miR-29a, miR-122, miR-155 and miR-181a with the degrees of inflammatory activity determined by NAS. miR-181a can be used as a non-invasive method of predicting fibrosis in NAFLD, and an association of biomarkers has the potential to increase the accuracy of each method alone.

Full Text
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