1. miRNAs in patients with non-alcoholic fatty liver disease: A systematic review and meta-analysis
- Author
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Manuel Romero-Gómez, Rocío Muñoz-Hernández, Antonio Gil-Gómez, Ángela Rojas, Rocío Montero-Vallejo, Rocío Gallego-Durán, Javier Ampuero, and Chang-Hai Liu
- Subjects
0301 basic medicine ,Liver Cirrhosis ,medicine.medical_specialty ,Disease ,Gastroenterology ,Severity of Illness Index ,03 medical and health sciences ,0302 clinical medicine ,Fibrosis ,Non-alcoholic Fatty Liver Disease ,Internal medicine ,medicine ,Humans ,Hepatology ,business.industry ,Fatty liver ,Area under the curve ,Publication bias ,medicine.disease ,digestive system diseases ,Up-Regulation ,MicroRNAs ,030104 developmental biology ,Meta-analysis ,Diagnostic odds ratio ,030211 gastroenterology & hepatology ,Steatohepatitis ,business ,Transcriptome ,Biomarkers - Abstract
Background & Aims microRNAs (miRNAs) are deregulated in non-alcoholic fatty liver disease (NAFLD) and have been proposed as useful markers for the diagnosis and stratification of disease severity. We conducted a meta-analysis to identify the potential usefulness of miRNA biomarkers in the diagnosis and stratification of NAFLD severity. Methods After a systematic review, circulating miRNA expression consistency and mean fold-changes were analysed using a vote-counting strategy. The sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratio and area under the curve (AUC) for the diagnosis of NAFLD or non-alcoholic steatohepatitis (NASH) were pooled using a bivariate meta-analysis. Deeks' funnel plot was used to assess the publication bias. Results Thirty-seven studies of miRNA expression profiles and six studies of diagnostic accuracy were ultimately included in the quantitative analysis. miRNA-122 and miRNA-192 showed consistent upregulation. miRNA-122 was upregulated in every scenario used to distinguish NAFLD severity. The miRNA expression correlation between the serum and liver tissue was inconsistent across studies. miRNA-122 distinguished NAFLD from healthy controls with an AUC of 0.82 (95% CI 0.75–0.89), and miRNA-34a distinguished non-alcoholic steatohepatitis (NASH) from non-alcoholic fatty liver (NAFL) with an AUC of 0.78 (95% CI 0.67–0.88). Conclusion miRNA-34a, miRNA-122 and miRNA-192 were identified as potential diagnostic markers to segregate NAFL from NASH. Both miRNA-122, in distinguishing NAFLD from healthy controls, and miRNA-34a, in distinguishing NASH from NAFL, showed moderate diagnostic accuracy. miRNA-122 was upregulated in every scenario of NAFL, NASH and fibrosis. Lay summary microRNAs are deregulated in non-alcoholic fatty liver disease. The microRNAs, miRNA-34a, miRNA-122 and miRNA-192, were identified as potential biomarkers of non-alcoholic fatty liver and non-alcoholic steatohepatitis, at different stages of disease severity. The correlation between miRNA expression in the serum and in liver tissue was inconsistent, or even inverse.
- Published
- 2018