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The Wide and Complex Field of NAFLD Biomarker Research: Trends

DOI: 10.1155/2014/846923

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Background. Nonalcoholic fatty liver disease is now acknowledged as a complex public health issue linked to sedentary lifestyle, obesity, and related disorders like type 2 diabetes and metabolic syndrome. Aims. We aimed to retrieve its trends out of the huge amount of published data. Therefore, we conducted an extensive literature search to identify possible biomarker and/or biomarker combinations by retrospectively assessing and evaluating common and novel biomarkers to predict progression and prognosis of obesity related liver diseases. Methodology. We analyzed finally 62 articles accounting for 157 cohorts and 45,288 subjects. Results. Despite the various approaches, most cohorts were considerably small and rarely comparable. Also, we found that the same standard parameters were measured rather than novel biomarkers. Diagnostics approaches appeared incomparable. Conclusions. Further collaborative investigations on harmonizing ways of data acquisition and identifying such biomarkers for clinical use are necessary to yield sufficient significant results of potential biomarkers. 1. Introduction Nonalcoholic fatty liver disease (NAFLD) is acknowledged as a (public) health issue with an estimated prevalence of 30% in adults [1], of which approximately 25% progresses to nonalcoholic steatohepatitis (NASH) [2]. Sedentary lifestyle and high-fat and high-caloric dietary intake are strongly associated with NAFLD and nonalcoholic steatohepatitis (NASH). NAFLD and NASH occur not only in adults but also increasingly in childhood [3–5], accounting for a tremendous economic health burden [6]. The pathways of NAFLD/NASH and their alcohol-induced counterpart diseases are multifactorial, involving the liver metabolism key players: cytokines, adipokines, and apoptosis [7]. Alternative tools such as ultrasound or magnetic resonance imaging (MRI) [8] are becoming common in clinical routine; anyway in NAFLD/NASH diagnostics liver biopsy still remains the golden standard [9, 10]. In the context of personalized medicine, the research on biomarker to identify NAFLD and its development and progression is high priority for clinical routine. Our systematic data analysis of NAFLD research conducted in the last year, based on evaluation of extensive literature search, provided an overview of the most commonly published potential biomarkers for NAFLD. 2. Methodology We performed an extensive literature assessment to evaluate known and novel biomarkers for progression and prognosis of NASH/NAFLD. In this context, we extracted and evaluated cohorts and parameters and consolidated

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