NAFLD and NASH pp 225-236 | Cite as

Integrative Proposal for the Use of Biomarkers in Clinical Practice Management of NAFLD/NASH

  • Carlos Benítez
  • Juan Pablo Arab
  • Francisco Barrera
  • Jesus M. Banales
  • Marco ArreseEmail author


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.


Nonalcoholic fatty liver disease Fatty liver disease Insulin resistance Biomarkers Liver fibrosis Steatosis 



Conflict of interest: The authors declare not to have conflict of interests related to this scientific work.

Funding: Financial support and sponsorship: This article was partially supported by the Chilean government through the Fondo Nacional de Desarrollo Científico y Tecnológico (FONDECYT 1191145 to M.A., 1200227 to JPA and 1191183 to F.B.) and the Comisión Nacional de Investigación Científica y Tecnológica (grant CONICYT PIA/Basal PFB12, Basal Centre for Excellence in Science and Technology to M.A.).

J.M. Banales received support from the Spanish Ministry of Economy and Competitiveness (FIS PI15/01132, FIS PI18/01075 and Miguel Servet Programme CON14/00129), cofinanced by “Fondo Europeo de Desarrollo Regional” (FEDER), CIBERehd (ISCIII), BIOEF (EiTB Maratoia BIO15/CA/016/BD), Department of Health of the Basque Country (2017111010), “Fundación Científica de la Asociación Española Contra el Cancer” (AECC Scientific Foundation) and La Caixa Foundation.


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Carlos Benítez
    • 1
  • Juan Pablo Arab
    • 1
    • 2
  • Francisco Barrera
    • 1
  • Jesus M. Banales
    • 3
    • 4
    • 5
  • Marco Arrese
    • 1
    • 2
    Email author
  1. 1.Departamento de Gastroenterología, Escuela de MedicinaPontificia Universidad Católica de ChileSantiagoChile
  2. 2.Centro de Envejecimiento y Regeneración (CARE), Departamento de Biología Celular y MolecularFacultad de Ciencias Biológicas Pontificia Universidad Católica de ChileSantiagoChile
  3. 3.Department of Liver and Gastrointestinal DiseasesBiodonostia Health Research Institute—Donostia University Hospital, University of the Basque Country (UPV/EHU), CIBERehd, IkerbasqueSan SebastianSpain
  4. 4.CIBERehd, Instituto de Salud Carlos IIIMadridSpain
  5. 5.Ikerbasque, Basque Foundation for ScienceBilbaoSpain

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