Metabolomics in Advanced Liver Disease

Abstract

Abstract Purpose of review Cirrhosis is one of the most important global public health problems. Patients with cirrhosis risk progression to acute-on-chronic liver failure (ACLF), associated with high mortality rates, and development of hepatocellular carcinoma (HCC). Metabolomics could identify urgently required novel biomarkers to improve disease diagnosis, monitor progression, and identify therapies. Recent findings In this review, current metabolic studies in decompensated cirrhosis, ACLF, and HCC over the past 3 years are summarised. Over numerous metabolomics studies, in cirrhosis, common alterations in proteins, carbohydrates, lipids, bile acids, and microbial metabolites were identified. In ACLF, changes in metabolites related to energy metabolism, amino acids, lipids, bile acids, and microbial metabolites were reported. Amino acids, bile acids, free fatty acids, and phospholipids were identified as important metabolite classes for discrimination between cirrhosis and HCC. Summary Metabolomics can improve our understanding of advanced liver diseases and provide the basis of the future studies and therapeutic advancements.