Unique metabolomics characteristics for distinguishing cirrhosis related to different liver diseases: A systematic review and meta-analysis.

ABSTRACT

BACKGROUND AND AIM: Clinical evidence for early identification and diagnosis of liver cirrhosis (LC) caused by different types of liver disease is limited. We investigated this topic through a meta-analysis of quantitative metabolomics. METHODS: Four databases were searched until October 31, 2022 for studies comparing metabolite levels between patients with different types of liver disease and control individuals. A random-effects model was applied for the meta-analysis. RESULTS: This study included 55 studies with 8266 clinical participants, covering 348 metabolites. In LC related to drug-induced liver injury (DILI), hepatitis B virus (HBV) infection, and non-alcoholic fatty liver disease (NAFLD), the primary bile acid biosynthesis (taurocholic acid SMD, 1.08[0.81, 1.35]; P < 0.00001; glycocholic acid SMD, 1.35[1.07, 1.62]; P < 0.00001; taurochenodeoxycholic acid SMD, 1.36[0.94, 1.78]; P < 0.00001; glycochenodeoxycholic acid SMD, 1.49[0.93, 2.06]; P < 0.00001), proline and arginine (l-proline SMD, 1.06[0.53, 1.58]; P < 0.0001; hydroxyproline SMD, 0.81[0.30, 1.33]; P = 0.002), and fatty acid biosynthesis (palmitic acid SMD, 0.44[0.21, 0.67]; P = 0.0002; oleic acid SMD, 0.46[0.19, 0.73]; P = 0.0008; stearic acid SMD, 0.37[0.07, 0.68]; P = 0.02) metabolic pathways were significantly altered. CONCLUSION: We identified key biomarkers and metabolic characteristics for distinguishing and identifying LC related to different types of liver disease, providing a new perspective for early diagnosis, disease monitoring, and precise treatment.