Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 21, 2015; 21(11): 3223-3231
Published online Mar 21, 2015. doi: 10.3748/wjg.v21.i11.3223
Biomarkers in nonalcoholic fatty liver disease-the emperor has no clothes?
Madhusudana Girija Sanal
Madhusudana Girija Sanal, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461, United States
Author contributions: Sanal MG conceived the issues which formed the content of the manuscript and wrote the manuscript.
Supported by IIP fellowship (2013-2014), Albert Einstein College of Medicine, New York, through the generosity of the Gruss Lipper Family Foundation.
Conflict-of-interest: The author does not have any conflict of interest associated with this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Madhusudana Girija Sanal, MBBS, PhD, IIP Research Fellow, Albert Einstein College of Medicine, Room#323, Ullmann Building, 1300 Morris Park Avenue, Bronx, NY 10461, United States.
Telephone: +1-347-3894440 Fax: +1-718-4303099
Received: November 22, 2014
Peer-review started: November 23, 2014
First decision: December 26, 2014
Revised: January 16, 2015
Accepted: February 11, 2015
Article in press: February 11, 2015
Published online: March 21, 2015
Core Tip

Core tip: Nonalcoholic fatty liver disease (NAFLD) is not a single disease, but encompasses a spectrum of diseases and this makes it very difficult to find highly specific and sensitive biomarkers. We should therefore aim to find relevant prognostic markers rather than accurate diagnostic markers which will help to minimize the frequency of liver biopsies to evaluate disease progression. There is no evidence that biopsy and detailed staging of NAFLD is important in the NAFLD management and benefits patients. Finally, there is no evidence based treatment for NAFLD other than management of ‘metabolic syndrome’ by pharmacological or non-pharmacological (lifestyle management/surgical) approaches.