Molecular Determinants of Chronic Liver Disease as Studied by NMR-Metabolomics

Chronic liver diseases are one of the major causess of mortality worldwide. It can manifest through many different forms including chronic virus infection, alcohol abuse, metabolic syndromes such as non-alcoholic fatty liver disease and non-alcoholic steatohepatitis. At early stages, the liver can repair the damage produced by the insult. However, upon continuous damage, the accumulation of molecules triggers fibrosis, which subsequently progresses towards cirrhosis and, ultimately, hepatocarcinoma. Early diagnosis of liver disease and a proper staging of fibrosis are crucial in therapy since drugs are only effective at incipient and intermediate stages of the disease. In this context, liver biopsy is the gold standard, but it is invasive and can produce complications. Metabolomics has emerged as a potent discipline to identify new biomarkers in a non-invasive way. Here, we compile and critically review the existing NMR-based metabolomics studies on chronic liver diseases, specifically covering non-alcoholic fatty liver disease, non-alcoholic steatohepatitis, alcoholic liver disease and those produced by virus infection.