Integrative proposal for the use of biomarkers in clinical practice management of NAFLD/NASH

Abstract

Identification of non-alcoholic fatty liver disease (NAFLD) and discrimination of the different subgroups of patients, grouped under this umbrella term are key issues in the field of liver diseases. While liver biopsy may still be used to diagnose and stage the disease, noninvasive tools (NITs) to appropriately asses the presence of NAFLD and its severity (i.e. presence of NASH) or degree of progression (i.e. presence of advanced fibrosis or cirrhosis) has been developed and validated in several cohorts during the last decade. These NITs include a wide variety of serum markers (i.e. routinely used serum parameters, biological markers of inflammation or fibrosis, microRNAs as well as lipid metabolites or panels serum proteins), equations combining serum markers and clinical features and advanced imaging techniques, either ultrasound-based or magnetic resonance-based, allowing to evaluate physical properties of the liver. In this chapter, we summarize the concepts reviewed in depth in previous chapters and propose the NITs to be used at present time to evaluate presence and severity of NAFLD in clinical practice.