Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease whose prevalence has been increasing constantly and linked to the global obesity epidemic. 

The NAFLD histologic spectrum ranges from simple steatosis to nonalcoholic steatohepatitis (NASH), which can progress to cirrhosis and hepatocellular carcinoma. 

Liver biopsy is the only reliable means to diagnose and stage NASH, but its invasive nature limits its use. 

Therefore, the prediction of hepatic injury by means of the development of new noninvasive tests represents a growing medical need. 

Dr Pamelaa Valva and colleagues evaluated matrix deposition and cell-death markers, which correlate with liver injury in an NAFLD patient cohort.

Liver biopsies and serum from 34 NAFLD adult patients were analyzed. 

Histological parameters were evaluated. 

Matrix deposition and cell-death markers were measured in serum samples.

The research team noted that HA showed an association with fibrosis severity, and M30 with steatosis, inflammation, and fibrosis severity. 

In contrast, TIMP-1 and M65 showed no association with any histological parameter of liver injury. 

The evaluation of diagnostic accuracy showed good performance as less invasive markers of significant fibrosis of both HA, and M30.

Dr Valva's team's team concludes, "Biomarkers are essential tools that may provide a quick and accurate diagnosis for patients with life-threatening NAFLD and NASH."

"HA and M30, together or determined sequentially, have been found to be straightforward tests that may be sufficient to predict significant fibrosis even in a primary care center of an underdeveloped country."