The quest for the ideal NASH biomarker

During the past two decades, the substantial increase of obesity and type 2 diabetes has brought awareness to their associated multiorgan complications. The liver is one of the main target organs, implying an increasing involvement of gastroenterologists in the care of non-alcoholic fatty liver disease (NAFLD), a condition involving both hepatology and endocrinology. Globally, more than 1 billion people are estimated to be affected by NAFLD, with a prevalence of 20–30%. 1 Riazi K Azhari H Charette JH et al. The prevalence and incidence of NAFLD worldwide: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2022; 7: 851-861 Summary Full Text Full Text PDF PubMed Scopus (198) Google Scholar With projections of further increases in non-communicable diseases, this number will continue to grow, leading to many more cases of advanced liver fibrosis and end-stage liver disease and expanding the waiting lists for liver transplantation that are already over capacity. 2 Burra P Becchetti C Germani G NAFLD and liver transplantation: disease burden, current management and future challenges. JHEP Rep Innov Hepatol. 2020; 2100192 Google Scholar Biomarkers for staging fibrosis and non-alcoholic steatohepatitis in non-alcoholic fatty liver disease (the LITMUS project): a comparative diagnostic accuracy studyNone of the single markers or multimarker scores achieved the predefined acceptable AUC for replacing biopsy in detecting people with both NASH and clinically significant fibrosis. However, several biomarkers could be applied in a prescreening strategy in clinical trial recruitment. The performance of promising markers will be further evaluated in the ongoing prospective LITMUS study cohort. Full-Text PDF Open Access