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August 27, 2020
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MiR-34a biomarker may rule-out NAFLD among healthy patients

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For healthy patients, miR-34a may be a reliable biomarker to effectively rule-out nonalcoholic fatty liver disease, according to research presented at The Digital International Liver Congress.

“MiR-34a concentrations increase with the presence of NAFLD and [nonalcoholic steatohepatitis],” Rémy Hanf, PhD, said during his presentation. “It distinguishes healthy [patients] for these populations. It has improved diagnostic components relative to other components and other NASH biomarkers. Among patients with suspicion of NAFLD, it could contribute to the identification of patients with active NASH who are higher risk for liver related complications.”

Hanf and colleagues measured miR-34a by reverse transcription quantitative polymerase chain reaction (RT-qPCR) in serum samples from 100 healthy blood donors and 1,214 patients with liver biopsy due to suspicion of NAFLD. They used NASH Clinical Research Network scoring systems to assess liver biopsies, NAFLD activity score and fibrosis stage, and collected patient data from independent cohorts.

Results showed that, compared with patients with NAFLD, blood donors had four times lower levels of miR-34a (Cq = 33.95 ± 0.56 vs. 31.97 ± 1.15; P < .0001). For patients with NAFLD, miR-34a levels in NAFL were twofold lower than in patients with NASH ([cycle quantification value (Cq)] = 32.79 ± 1.01 vs. 31.84 ± 1.11; P < .0001). Therefore, Hanf and colleagues believe miR-34a may be a ‘robust’ biomarker to distinguish healthy patients from patients with NAFLD (AUC = 0.94), NAFL (AUC = 0.85) or NASH (AUC = 0.96). Levels of miR-34 increased with NAFLD activity score and fibrosis stage (P < .0001) among all patients.

Study data also showed higher levels of miR-34a in patients with active NASH and significant fibrosis compared with patients without (Cq = 31.38 ±1.02 vs. 32.55 ± 1.02; P < .0001), with an AUC of 0.8.

“When compared to other commonly used biomarkers such as alanine aminotransferase, aspartate aminotransferase, CK18-M30 and M65, A2M, TIMP1 or hyaluronic acid, [miR-34a] performance was superior to all of these with the exception of CK18-M30 and M65,” Hanf said.