The Health Medicine Network has shared that researchers found a potential early biomarker that could help track the development of non-alcoholic fatty liver disease. With up to 80% of obese pediatric patients and a wide variety of adult patients experiencing this disease, this biomarker could be key to future treatment options. Read the full study published in the Journal of Clinical Investigation.
About Non-Alcoholic Fatty Liver Disease
Non-alcoholic fatty liver disease (NAFLD) is a condition which occurs when excess fat deposits build up in the liver. While fat in the liver is not an issue by itself, it becomes problematic when more than 5-10% of the liver’s overall weight is attributed to fat. Symptoms of non-alcoholic fatty liver disease include abdominal pain, fatigue, and jaundice. The condition affects over one billion people worldwide. Learn more about non-alcoholic fatty liver disease here.
However, NAFLD can progress in some patients to become nonalcoholic steatohepatitis (NASH). NASH may also occur in patients who have not before had NAFLD, and is considered a more severe subset of the condition. Nonalcoholic steatohepatitis occurs when the buildup of fat leads to inflammation and cirrhosis. Symptoms include weakness, weight loss, jaundice, swelling of the legs and abdomen, mental confusion, and abdominal pain. Learn more about NASH here.
About the Study
Currently, there are little to no treatment options, cures, or even early detection methods for non-alcoholic fatty liver disease. But with certain subsets of the population, like people with diabetes, being more heavily affected, researchers wanted to understand how to better address patient needs in this setting.
Hypothesis
Prior studies considered that genetics could play a role in which patients developed NAFLD. Researchers on this study questioned whether environmental factors, like the health status (metabolism, obesity, cholesterol and insulin levels) of a patient’s parents or family, may also play a part.
To test this, researchers first focused on two groups of mice models: one that was not genetically modified, and one that was genetically modified to have metabolic syndrome. Metabolic syndrome encompasses the markers of health status listed above. The offspring of these models were then split into three groups: one parent with metabolic syndrome, both parents, or neither parent.
Genetically normal offspring were given either a normal diet or high-caloric diet. The mice eating a normal diet did not increase in body fat. But the others saw a large increase in body fat. The group with high body fat also saw increased cholesterol, triglycerides, and liver fat.
Findings on Non-Alcoholic Fatty Liver Disease
The study found that a protein called neuronal regeneration related protein (NREP) was a biomarker related to the development of NAFLD. Additionally, NREP could create new treatment options for patients. According to researchers, NREP acts to regulate liver fat metabolism. It also acts in the development of fibrosis, or the formation of hardened tissue (scar tissue).
The mice with high body fat had less NREP than the other group. As a result, researchers wondered what would happen if they increased or decreased NREP. They exacted this in culture dishes holding human liver cells. Decreased NREP led to higher cholesterol and was associated with fibrosis.
Next, researchers studied data from patients with varying stages of liver disease. They discovered a clear pattern of NREP decreasing at the onset of non-alcoholic fatty liver disease. Thus, NREP is a biomarker for NAFLD. Tracking it can allow doctors to detect NAFLD in patients and start addressing the condition earlier.
ATP Citrate Lyase (ACLY)
In addition to acting as a biomarker, NREP also regulates the protein ATP citrate lyase. This enzyme handles fatty acid synthesis. Currently, clinical trials are testing ACLY as a potential treatment for NAFLD.
With the new biomarker and potential treatment pathway, researchers are now on their way towards developing more personalized care options for patients with NAFLD.
