Ability of a Combined FIB4/miRNA181a Score to Predict Significant Liver Fibrosis in NAFLD Patients

Abstract

Liver biopsy is the gold standard for assessing fibrosis, but there is a need to seek non-invasive biomarkers for this purpose. The aim of this study was to evaluate the correlation between the serum levels of the microRNAs miR-21, miR-29a, miR-122, miR-155 and miR-181a and the phenotypic expression of NAFLD. A cross-sectional study was carried out on 108 NAFLD patients diagnosed by liver biopsy. FIB-4 and NAFLD fibrosis scores were calculated. The comparison between the distributions of microRNA values according to the presence or absence of histological fibrosis (F2–F4) was performed. A multivariate logistic regression analysis was performed to build a score for predicting fibrosis using FIB-4 and Ln (miR-181a) as independent variables. Only miR-181a showed a statistical difference between patients with significant liver fibrosis (>F2) and those without (F0–F1) (p = 0.017). FIB-4 revealed an AUC on the ROC curve of 0.667 to predict clinically significant fibrosis (F2–F4). When assessed using the score in association with Ln (miR-181a), there was an improvement in the ROC curve, with an AUC of 0.71. miR-181a can be used as a non-invasive method of predicting fibrosis in NAFLD, and an association with FIB-4 has the potential to increase the accuracy of each method alone.

NAFLD: From Mechanisms to Therapeutic Approaches

“…New non-invasive tools are therefore required for the diagnosis of steatosis and fibrosis, allowing a reliable identification of individuals at risk who can be referred to hepatologists. Several papers published in this issue discuss the potential role of various approaches to detect NAFLD non-invasively and assess its severity, including machine-learning-based or combined screening tools such as plasmatic microRNAs and imaging [ 4 , 5 , 6 , 7 , 8 ]. The implementation of comprehensive screening programs is urgently needed to improve the management of this disorder and unexpensive non-invasive screening tests may have a significant positive impact on this aspect.…”