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Abstract Non‐alcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease worldwide. NAFLD is considered to represent the hepatic manifestation of metabolic syndrome. NAFLD was traditionally considered as a relatively benign liver disease. However, some patients with NAFLD progress to liver fibrosis, cirrhosis and hepatocellular carcinoma 8-13. Therefore, the precise diagnosis and staging of NAFLD patients is clinically important. Liver biopsy is the gold standard for the evaluation of NAFLD patients in terms of staging. However, liver biopsy is an invasive technique, and the identification of non‐invasive biomarkers is required. Micro‐RNAs (miRNAs) are endogenous, small, non‐coding RNAs of approximately 21–22 nucleotides that have important gene regulatory functions in animals and plants. miRNAs bind to the messenger RNAs of protein coding genes to direct their post‐transcriptional repression. miRNAs have been reported to play important roles in cell proliferation and apoptosis, lymphocyte development, and adipocyte differentiation. Several recent studies have indicated that miRNAs play important roles in metabolism and metabolic diseases. MicroRNA‐122 (miR‐122) is the most abundant miRNA in the liver, and it regulates metabolic pathways, including cholesterol biosynthesis, fatty acid synthesis and oxidation. In the present study, we assess the value of MicroRNA-122 as a non-invasive biomarker for diagnosis of NAFLD and NASH related Cirrhosis. The current study showed that: • The mean age was significantly higher within the NASH group than NAFLD group than Control group. • Body weight and BMI were higher in the NASH than in the NAFLD and control groups. • Patients with NASH had lower platelet count than normal controls and NAFLD patients. Likewise, patients with NAFLD had lower platelet count than normal controls. • Patients with NASH had higher INR than the NAFLD. • Patients with NASH had lower serum albumin, higher total bilirubin, higher serum AST, and higher serum ALT than normal controls. Likewise, patients with NAFLD had lower serum albumin, higher total bilirubin, higher serum AST, and higher serum ALT than normal controls • Patients with NASH had higher serum FBS and serum cholesterol than normal controls. Likewise, patients with NAFLD had higher serum FBS and serum cholesterol than normal controls • Patients with NASH had higher NAFLD score than patients with NAFLD than normal control. • Patients with NASH had significantly higher frequency of upregulated miRNA-22. • Patients with NASH had higher miRNA 122 expression than normal controls and patients with NAFLD. Likewise, patients with NAFLD had higher miRNA 122 expression than normal controls. • The miRNA 122 was a significant discriminator of NAFLD and NASH with a sensitivity of 75% and specificity of 82% for NAFLD and a sensitivity of 91% and specificity of 86% for the NASH. |