Evaluation of microRNA-34a as a molecular link between insulin resistance and nonalcoholic fatty liver disease

Abstract Background Non-alcoholic fatty liver disease (NAFLD) is a chronic progressive disease of the liver that occurs in the absence of excessive alcohol consumption, evolving from simple hepatic steatosis, non-alcoholic steatohepatitis (NASH), fibrosis to cirrhosis and hepatocellular carcinoma (HCC). With a global prevalence of 25.24% (22.10-28.65), NAFLD has become a major public health problem. The principal risk factors associated with NAFLD include metabolic syndrome such as obesity, type-2 diabetes and hyperlipidemia. In particular, the prevalence of obesity in European patients with NAFLD varied from 25% to 94%. Insulin resistance resulting in a hyperinsulinemic state increases de novo lipogenesis, which further exacerbates hepatic lipid deposition and boosts the development of the disease. Objective The aim of this study is to evaluate Circulating microRNA-34a as a molecular link between insulin resistance and nonalcoholic fatty liver disease. Methods This study was carried out on 40 participants between June 2017 and June 2018. They were classified into 2 groups: Group I included 20 patients newly diagnosed as Nonalcoholic fatty liver disease (NAFLD) and had not received any treatment. Group II included 20 apparently healthy volunteers defined as those with normal transaminases, normal hepatic ultrasound and negative for HBsAg, HCV¬Ab. Results Results were compared to results of similar researches; where this study found that there was statistically significant increase in MiR-34a levels in group I Clan group II with p-value < 0.001. Also there was statistically significant positive correlation between MiR-34a and age, BMI, HOMA-IR, NAFLD-fibrosis score, ALT, AST, TGs, F.ins and F.Glu. The best cut off point to differentiate between normal and NAFLD group regarding MIR34-a was found > 1.46 with sensitivity of 80%, specificity of 100% and area under curve (AUC) of 92.2%. Conclusion Circulating microRNA-34a provides a good molecular link between insulin resistance and nonalcoholic ratty liver disease. All data were statistically analyzed. Results were compared to results of similar researches; where this study found that the best cut off point to differentiate between normal and NAFLD group regarding MIR34-a was found > 1.46 with sensitivity of 80%, specificity of 100% and area under curve (AUC) of 92.2%.