The ability to detect fibrosis early in NAFLD patients is critical to controlling the mortality associated with this highly prevalent disease. We investigated the association between plasma biomarkers with steatosis and hepatic fibrosis in order to identify markers of disease activity and severity in patients with NAFLD.

Five plasma biomarkers, including TGF-β, IL-10, IL-1β, IL-2, MMP2, and MMP9, were measured in study participants with non-alcoholic fatty liver disease (NAFLD). The status of steatosis and hepatic fibrosis in NAFLD patients was evaluated using transient elastography. Univariate and multivariate logistic regression analysis was performed to identify Biomarkers associated with NAFLD, steatosis and hepatic fibrosis.

Of 80 patients (40% female, mean age 39.20 years), 32.5% had fibrosis (stages 1-4), 32.5% had mild steatosis, and 67.5% had moderate or severe steatosis (S> 33%). Increased MMP-2 (OR: 1.01, CL 95%: 1.01–1.02, P = 0.001) and decreased IL-10 (OR: 0.95, CL 95%: 0.91–0.98, P = 0.004) had a strong association with definite NAFLD compared to the healthy group in multivariable analysis. Biomarkers associated with fibrosis and steatosis (moderate / severe) in multivariable analysis included MMP-2 (OR: 1.00; 95% CI: 1.00–1.01; P = 0.01) and MMP-9 (OR: 1.02; 95% CI: 1.011–1.04; P < 0.01), respectively.

MMP-2 and MMP-9 are significantly associated with the severity of fibrosis and steatosis in NAFLD and are potentially valuable tools for the noninvasive stratification of patients with NAFLD and the identification of targets for therapeutic intervention.