Abstract: Objective The aim of this study was to explore the diagnostic performance of serum proneurotensin (Pro-NT), a adipose cytokine level and micro RNA (miRNA) load in patients with nonalcoholic steatohepatitis (NASH). Methods 159 patients with nonalcoholic fatty liver diseases (NAFLD) and 90 healthy persons were recruited in our hospital between January 2017 and June 2022, and the NAFLD was diagnosed by ultrasonography. Serum Pro-NT level was detected by ELISA, and serum miRNA load was assayed by RT-PCR. All patients with NAFLD received liver biopsies and the NASH was determined by histopathological examination. The area under the receiver operating characteristic curve (AUC) was applied to assess the diagnostic efficacy of serum parameters. Results Out of the 159 patients with NAFLD, the liver tissue examination found NASH in 49 cases (30.8%) and simple NAFLD in 110 cases (69.2%); the body mass index in patients with NASH was (28.4±1.2)kg/m², much greater than in patients with NAFLD; serum ALT, AST, fasting blood glucose, insulin, HOMA-IR and uric acid levels in patients with NASH were 62(48, 96)U/L, 56(47, 85)U/L, (5.9±0.6)mmol/L, 10.2(8.8, 13.4)μU/mL, 2.6(1.8, 3.4) and 496(392, 515)μmol/L, all significantly higher than 38(25, 53)U/L, 32(21, 49)U/L, (5.3±0.6)mmol/L, 9.0(7.2, 12.6)μU/mL, 2.2(1.3, 2.7) and 446(351, 495)μmol/L, respectively, P<0.05] in patients with NAFLD; serum Pro-NT level and miRNA-122 load were 167(148.4, 186.9)pmol/L and 8.2(2.0, 29.3), much higher than in patients with NAFLD; all the parameters in patients with NAFLD were much higher than in healthy persons (P<0.05); the diagnostic performance by serum Pro-NT level (≥112 pmol/L as the cut-off-value) was much superior to serum miRNA-122 (≥7.08 as the cut-off-value) by Delongin test in predicting the existence of NASH, with the AUC of 0.824, the sensitivity of 80.0%, the specificity of 80.0%, the positive predictive value of 84.9% and the negative predictive value of 82.3%, to 0.637, 56.0%, 70.0%, 76.5% and 56.8% (P<0.05) by serum miRNA-122. Conclusion Serum Pro-NT level might be acted as a non-invasive parameter for surveillance and screening of NASH in patients with NAFLD, and warrants further clinical investigation.

Key words: Nonalcoholic steatohepatitis, Proneurotensin, Micro RNA , Diagnosis