Moreover, liver biopsy has potential complications such as bleeding, especially when patients are in decompensated conditions. Liver biopsy is the gold standard for diagnosis and staging of NASH however, its clinical application is restricted by patients’ reluctance. Therefore, early diagnosis of NAFLD, in particular NASH, is important. However, recent research found that NASH can progress to HCC without fibrosis and cirrhosis. The traditional view suggests that HCC formation is a multi-stage process, involving inflammation, fibrosis and cirrhosis. Furthermore, some studies have indicated that NASH patients have a 60% greater chance of progression to HCC than that of NAFL patients. Studies have shown that approximately one-sixth of NAFL patients progress to NASH, and 20% of NASH patients can develop cirrhosis. It should be noted that NASH is a crucial stage during NAFLD progression. NAFLD comprises a spectrum of pathological conditions, including simple steatosis (NAFL), nonalcoholic steatohepatitis (NASH), fibrosis, cirrhosis and hepatocellular carcinoma (HCC). In developing countries such as China, the prevalence has reached up to 32.9%. In developed countries such as the United States, the prevalence of NAFLD is 30%.
According to the latest epidemiological studies, the prevalence of NAFLD is approximately 25% worldwide. Non-alcoholic fatty liver disease (NAFLD) has become a major burden among chronic liver diseases. Diagnosis of NAFLD by serum miRNA is more likely to be accurate in patients with BMI ≥ 30 kg/m 2. Among these well-studied miRNAs, miRNA-34a was more available for diagnosis. ConclusionsĪs a novel non-invasive method, serum miRNA test exhibited robust diagnostic efficacy for NASH. According to subgroup analysis and meta-regression, a lower BMI (< 30 kg/m 2) might be a crucial source of heterogeneity. Among the most commonly studied serum miRNAs, miRNA-34a showed moderate diagnostic accuracy for NAFLD and the lowest heterogeneity (sensitivity I 2 = 5.73%, specificity I 2 = 33.16%, AUROC = 0.85).
Serum miRNA had high accuracy for distinguishing NASH from simple steatosis, with an AUROC of 0.91. For NAFLD vs NASH, the pooled sensitivity, specificity, and AUROC were (0.71 vs. We included 27 trials containing 1775 NAFLD patients (including simple steatosis and NASH) and 586 NASH patients. Publication bias was detected by Deeks’ funnel plot. Heterogeneity was evaluated by subgroup analysis and meta-regression. Clinical utility was evaluated by Fagan’s nomogram and likelihood ratio scattergram. MethodsĪfter a systematic review, sensitivity, specificity, and area under the receiver operating characteristics curve (AUROC) were pooled to determine the efficacy of serum miRNA test for the diagnosis of NAFLD and NASH. We conducted a meta-analysis to assess the evidence for the diagnostic efficacy of serum miRNAs in patients with NAFLD and its subtype, NASH, in particular.
Recent studies have shown that serum miRNA tests may be effective in the diagnosis of NAFLD. Nonalcoholic steatohepatitis (NASH) is a key turning point during the progression of nonalcoholic fatty liver disease (NAFLD).