1 Serum miR-379 expression is related to the development and progression of 2 hypercholesterolemia in non-alcoholic fatty liver disease 3 4 Short title: Serum miR-379 relates hypercholesterolemia in NAFLD 5 6 Abstract28 Introduction: Non-alcoholic fatty liver disease (NAFLD) has a wide spectrum, 29 eventually leading to cirrhosis and hepatic carcinogenesis. We previously reported that 30 a series of microRNAs (miRNAs) mapped in the 14q32.2 maternally imprinted gene 31 region (Dlk1-Dio3 mat) are related to NAFLD development and progression in a mouse 32 model. We examined the suitability of miR-379, a circulating Dlk1-Dio3 mat miRNA, 33 as a human NAFLD biomarker.34 Methods: Eighty NAFLD patients were recruited for this study. miR-379 was selected 35 from the putative Dlk1-Dio3 mat miRNA cluster because it exhibited the greatest 36 expression difference between NAFLD and non-alcoholic steatohepatitis in our 37 preliminary study. Real-time PCR was used to examine the expression levels of 38 miR-379 and miR-16 as an internal control.39 Results: Compared to normal controls, serum miR-379 expression was significantly 40 up-regulated in NAFLD patients. Receiver operating characteristic curve analysis 41 suggested that miR-379 is a suitable marker for discriminating NAFLD patients from 42 controls, with an area under the curve value of 0.72. Serum miR-379 exhibited positive 43 correlations with alkaline phosphatase, total cholesterol, and low-density-lipoprotein 44 cholesterol levels in patients with early stage NAFLD (Brunt fibrosis stage 0 to 1). The 45 correlation between serum miR-379 and cholesterol levels was lost in early stage 46 NAFLD patients treated with statins. Software-based predictions indicated that various 47 energy metabolism-related genes, including insulin-like growth factor-1 (IGF-1) and48 IGF-1 receptor, are potential targets of miR-379.49 Conclusions: Serum miR-379 exhibits high potential as a biomarker for NAFLD.50 miR-379 appears to increase cholesterol lipotoxicity, leading to the development and 4 51 progression of NAFLD, via interference with the expression of target genes, including 52 those related to the IGF-1 signaling pathway. Our results could facilitate future research 53 into the pathogenesis, diagnosis, and treatment of NAFLD.
54 Introduction
55Non-alcoholic fatty liver disease (NAFLD) is an important cause of chronic liver 56 injury, with an increasing incidence worldwide [1]. NAFLD, regarded as a hepatic 57 manifestation of metabolic syndrome, is defined by significant lipid deposition in 58 hepatocytes (excessive numbers of fat-laden hepatocytes are observed by light 59 microscopy), unrelated to excessive alcohol consumption [2]. The prevalence of 60 NAFLD is almost 25% worldwide and expected to increase with increasing incidence of 61 obesity and metabolic diseases such as type 2 diabetes mellitus (T2DM) and 62 hyperlipidemia [3].
63The mechanism underlying the development of NAFLD has not been fully 64 elucidated. Currently, the multiple parallel hit theory is the most widely ac...