MicroRNAs in Metabolic Dysfunction-Associated Steatotic Liver Disease: A Systematic Review of Clinical Studies.

Introduction: Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is a major contributor to global morbidity and mortality. As diagnostic tools for MASLD remain limited, microRNAs (miRs) have garnered attention as promising biomarkers due to their roles in regulating metabolic pathways and reflecting disease states.

Method: This systematic review of clinical studies explores the association between miRNAs and the spectrum of MASLD-related pathologies, including steatosis, fibrosis, and Hepatocellular Carcinoma (HCC). A comprehensive literature search was conducted using PRISMA guidelines, resulting in 44 peer-reviewed studies being included. The review identifies several key miRs, such as miR-122, miR-34a, and miR-193-5p, which are linked to lipid metabolism, insulin resistance, and MASLD severity.

Results: Additionally, miR-214 and miR-193-5p are highlighted as potential biomarkers for fibrosis, while miR-21 and miR-34a are implicated in the progression of HCC. These miRs were found in various tissues, including serum, liver, visceral adipose tissue, and ascitic fluid, demonstrating their utility as diagnostic and prognostic tools across the MASLD spectrum.

Conclusion: While miR panels are being developed for clinical assessment, further research is required to confirm their roles in diagnosis and treatment, as well as their integration into routine clinical practice.