title: Serum metabolomic profile and potential biomarkers for severity of fibrosis in nonalcoholic fatty liver disease.
abstract: BACKGROUND
  Biomarker for usefulness in diagnosing advanced fibrosis in nonalcoholic fatty liver disease (NAFLD) is expected. In order to discover novel biomarkers for NAFLD and its pathogenesis, we performed matabolomics screening.
  
  
  METHODS
  (1) The initial cohort was 44 NAFLD patients. (2) This validation cohort was 105 NAFLD patients, 26 primary biliary cirrhosis (PBC) patients, and 48 healthy controls. Using capillary electrophoresis and liquid chromatography with mass spectrometry, we analyzed low molecular weight metabolites in these groups.
  
  
  RESULTS
  1. In the initial cohort, we found 28 metabolites associated with advanced fibrosis. Among them, 4 sulfated steroids showed the greatest difference. A decrease of dehydroepiandrosterone sulfate (DHEA-S) and 5α-androstan-3β ol-17-one sulfate (etiocholanolone-S) was observed with the progression of fibrosis. Furthermore, 16 hydroxydehydroepiandrosterone sulfate (16-OH-DHEA-S) increased with the progression of fibrosis. 2. In the validation cohort, the decrease of DHEA-S and etiocholanolone-S, as well as the increase of 16-OH-DHEA-S, with the progression of fibrosis was confirmed. The 16-OH-DHEA-S/DHEA-S ratio and 16-OH-DHEA-S/etiocholanolone-S ratio were even more strongly associated with the grade of fibrosis. Among PBC patients, 16-OH-DHEA-S tended to be higher in stages 3 and 4 than in stages 1 and 2. However, levels of DHEA-S, etiocholanolone-S, and the two ratios were not associated with the stage of PBC.
  
  
  CONCLUSIONS
  Several metabolic products were found to be biomarkers of fibrosis in NAFLD and could also be useful for diagnosis of this condition. Our findings suggested disturbance of hormone metabolism in NAFLD and might lead to the development of new therapy.
authors.affiliation: Department of Internal Medicine and Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Tokushige
authors.forename: Etsuko
authors.initials: E
authors.lastname: Hashimoto
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Kodama
authors.forename: Maki
authors.initials: M
authors.lastname: Tobari
authors.forename: Noriko
authors.initials: N
authors.lastname: Matsushita
authors.forename: Tomomi
authors.initials: T
authors.lastname: Kogiso
authors.forename: Makiko
authors.initials: M
authors.lastname: Taniai
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Torii
authors.forename: Keiko
authors.initials: K
authors.lastname: Shiratori
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Nishizaki
authors.forename: Takushi
authors.initials: T
authors.lastname: Ohga
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Ohashi
authors.forename: Takaya
authors.initials: T
authors.lastname: Sato
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism; D016022:Case-Control Studies; D002853:Chromatography, Liquid / Q000379:methods; D015331:Cohort Studies; D018450:Disease Progression; D019075:Electrophoresis, Capillary / Q000379:methods; D005234:Fatty Liver / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology*; D008105:Liver Cirrhosis, Biliary / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology*; D008297:Male; D013058:Mass Spectrometry / Q000379:methods; D055432:Metabolomics / Q000379:methods*; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers