Serum Microrna-122 is Associated with the Therapeutic Response to Diet and Exercise Therapy in Patients with Steatotic Liver Disease.

Objective Steatotic liver disease (SLD) is a prevalent chronic liver disease for which lifestyle intervention remains the first-line treatment. However, reliable biomarkers that reflect treatment responsiveness are limited. MicroRNA-122 (miR-122) is a liver-specific microRNA involved in hepatic lipid metabolism and injury. However, its clinical significance during lifestyle intervention has not yet been fully elucidated. Methods This single-center retrospective study enrolled 144 patients with SLD who underwent a 6-day inpatient individualized diet and exercise program. The serum miR-122 levels were measured at baseline and on Day 4 of hospitalization. The primary endpoint was defined as ≥10% improvement in alanine aminotransferase (ALT) levels at 6 months. Multivariate logistic regression analyses were performed to identify the factors independently associated with ALT improvement. Results The liver function and metabolic parameters improved significantly at 6 months. The median ALT improvement rate was 13.4%. An exploratory receiver operating characteristic analysis demonstrated that baseline miR-122 moderately discriminated against ALT improvement ≥10% (area under the curve [AUC] 0.663, 95% confidence interval [CI] 0.572-0.753). In a multivariate analysis, the baseline miR-122 was independently associated with ALT improvement after adjusting for age, sex, alcohol consumption, body mass index, and baseline ALT. Early changes in miR-122 on Day 4 were not independently associated with the 6-month outcomes. Conclusion Individualized dietary and exercise therapy based on a multifaceted approach is effective for SLD. The baseline serum miR-122 levels were associated with a biochemical ALT improvement following lifestyle intervention in patients with SLD. Circulating miR-122 may serve as a response-associated biomarker reflecting the biochemical responsiveness to lifestyle intervention.