title: Noninvasive biomarkers in non-alcoholic fatty liver disease: current status and a glimpse of the future.
abstract: The development of non invasive biomarkers of disease has become a major focus of interest in nonalcoholic fatty liver disease (NAFLD). The large prevalence of the disease and the invasive nature of the investigation means that screening with liver biopsy is impractical. In addition to screening, the differentiation of those with simple steatosis vs steatohepatitis and fibrosis is clinically important as the prognosis of each differs. Serum biomarkers may be a combination of simple markers derived from large data sets or direct markers of disease activity. Serum markers of inflammation, apoptosis and oxidative stress in addition to fibrosis have been extensively studied in patients with NAFLD. Other techniques such as transient elastography, magnetic resonance elastography and acoustic radiation force imaging are becoming more established as noninvasive methods of detecting fibrosis in a variety of chronic liver conditions in addition to NAFLD. Newer high throughput methods such as proteomics and glycomics allow the nonhypothesis-driven identification of novel markers and may also potentially contribute to our understanding of the pathogenesis of the condition. This review addresses some of the methodological issues which need to be considered in the search for the ideal biomarker. It is likely that a combination of serum biomarkers and techniques such as transient elastography may provide the optimal diagnostic discrimination however this remains to be proven in large studies.
authors.affiliation: Emer Fitzpatrick, Anil Dhawan, Paediatric Liver, GI and Nutrition Centre, King's College London School of Medicine at King's College Hospital, London SE5 9PJ, United Kingdom.
authors.forename: Emer
authors.initials: E
authors.lastname: Fitzpatrick
authors.affiliation: Emer Fitzpatrick, Anil Dhawan, Paediatric Liver, GI and Nutrition Centre, King's College London School of Medicine at King's College Hospital, London SE5 9PJ, United Kingdom.
authors.forename: Anil
authors.initials: A
authors.lastname: Dhawan
mesh_terms: D000328:Adult; D000367:Age Factors; D015415:Biomarkers / Q000097:blood*; D002648:Child; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging / Q000379:methods; D004548:Elasticity; D054459:Elasticity Imaging Techniques / Q000379:methods; D020869:Gene Expression Profiling / Q000379:methods; D020022:Genetic Predisposition to Disease; D006801:Humans; D008099:Liver / Q000378:metabolism / Q000473:pathology; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis / Q000235:genetics / Q000473:pathology; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D011237:Predictive Value of Tests; D011379:Prognosis; D040901:Proteomics / Q000379:methods; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers
keywords: Fibrosis; Nonalcoholic fatty liver disease; Noninvasive biomarkers