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Relationship Between Methylome and Transcriptome in Patients With Nonalcoholic Fatty Liver Disease
Open accessAbstract
Background & aims Cirrhosis and liver cancer are potential outcomes of advanced nonalcoholic fatty liver disease (NAFLD). It is not clear what factors determine whether patients will develop advanced or mild NAFLD, limiting noninvasive diagnosis and treatment before clinical sequelae emerge. We investigated whether DNA methylation profiles can distinguish patients with mild disease from those with advanced NAFLD, and how these patterns are functionally related to hepatic gene expression.Methods We collected frozen liver biopsies and clinical data from patients with biopsy-proven NAFLD (56 in the discovery cohort and 34 in the replication cohort). Samples were divided into groups based on histologic severity of fibrosis: F0-1 (mild) and F3-4 (advanced). DNA methylation profiles were determined and coupled with gene expression data from the same biopsies; differential methylation was validated in subsets of the discovery and replication cohorts. We then analyzed interactions between the methylome and transcriptome.Results Clinical features did not differ between patients known to have mild or advanced fibrosis based on biopsy analysis. There were 69,247 differentially methylated CpG sites (76% hypomethylated, 24% hypermethylated) in patients with advanced vs mild NAFLD (P < .05). Methylation at fibroblast growth factor receptor 2, methionine adenosyl methyltransferase 1A, and caspase 1 was validated by bisulfite pyrosequencing and the findings were reproduced in the replication cohort. Methylation correlated with gene transcript levels for 7% of differentially methylated CpG sites, indicating that differential methylation contributes to differences in expression. In samples with advanced NAFLD, many tissue repair genes were hypomethylated and overexpressed, and genes in certain metabolic pathways, including 1-carbon metabolism, were hypermethylated and underexpressed.Conclusions Functionally relevant differences in methylation can distinguish patients with advanced vs mild NAFLD. Altered methylation of genes that regulate processes such as steatohepatitis, fibrosis, and carcinogenesis indicate the role of DNA methylation in progression of NAFLD.
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“Moreover, certain patterns of DNA methylation at fibrosis-related genes, such as those encoding TGFβ1, COL1A1, PDGFα, peroxisome proliferator-activated receptor alpha (PPARα), and peroxisome proliferator-activated receptor delta (PPARδ), can not only distinguish between patients with mild versus advanced MASLD, but also predict future fibrosis progression (169-172).”
From Found in translation—Fibrosis in metabolic dysfunction–associated steatohepatitis (MASH) (2023) · cites this paper as [169]
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Stols‐Gonçalves, D., Meijnikman, A. S., Tristão, L. S., dos Santos, C. L., Denswil, N. P., Verheij, J., Bernardo, W. M., & Nieuwdorp, M. (2024) · Cells · doi:10.3390/cells13221893 · Cited by 11
Kurokawa, S., Yoneda, M., Ogawa, Y., Honda, Y., Kessoku, T., Imajo, K., Saito, S., Nakajima, A., & Hotta, K. (2022) · BMC Gastroenterology · doi:10.1186/s12876-022-02360-4 · Cited by 9
“For DNA methylation analysis, we used the following datasets: our recently published Japanese hepatic DNA methylation data of NAFLD (JGAS000059, http:// trace. ddbj. nig. ac. jp/ jga/ index. html) [13], American hepatic DNA methylation data of NAFLD (NCBI Gene Expression Omnibus accession number GSE31803) [15], Japane…”
BackgroundInfluentialThe Roles of Natural Compounds in Epigenetics
Yang, Y., Chi, Z.-H., Gao, R., & Lei, Z. (2018) · Natural Product Communications · doi:10.1177/1934578x1801300835 · Cited by 9
Lefever, D. E., Miedel, M. T., Pei, F., DiStefano, J. K., DeBiasio, R., Shun, T. Y., Saydmohammed, M., Chikina, M. D., Vernetti, L. A., Soto–Gutiérrez, A., et al. (2022) · Metabolites · doi:10.3390/metabo12060528 · Cited by 12
“mild fibrosis) [79] (Figure S3; for details see https://github.”
BackgroundNutrients as epigenetic modulators in metabolic dysfunction-associated steatotic liver disease
Rodríguez, S., Dahlem, M. L. F., Rossoni, C., Marroni, N. P., Marroni, C. A., & Fernandes, S. A. (2025) · World Journal of Hepatology · doi:10.4254/wjh.v17.i8.108182 · Cited by 8
Hagemann, C. A., Legart, C., Møllerhøj, M. B., Madsen, M. R., Hansen, H. H., Kønig, M. J., Helgstrand, F., Hjørne, F., Toxværd, A., Langhoff, J. L., et al. (2022) · PLoS ONE · doi:10.1371/journal.pone.0275901 · Cited by 10
“…of α 2AP have been associated with advanced liver fibrosis in two studies characterizing the plasma proteome in NAFLD patients and controls [9, 43], and decreased plasma concentrations of SAM and hepatic expression levels of MAT1A have been associated with NAFLD and/ or liver fibrosis [12, 44, 45].”
EMP1 as a Potential Biomarker in Liver Fibrosis: A Bioinformatics Analysis
Chen, X., Lv, X., Han, M., Hu, Y., Zheng, W., Xue, H., Li, Z., Li, K., & Tan, W. (2023) · Gastroenterology Research and Practice · doi:10.1155/2023/2479192 · Cited by 10
“Moreover, EMP1 is greater higher expressed in samples of NAFLD liver biopsy tissues recovered from advanced (fibrotic stage 3–4) compared to moder- ate samples (fibrotic stage 0–1) in GSE49541 (log2FC=1.152, P = 3:26 × 10−4; Figure 3(h)).”
MethodInfluentialDietary Pattern’s Role in Hepatic Epigenetic and Dietary Recommendations for the Prevention of NAFLD
Martin, J., & Bars‐Cortina, D. (2024) · Nutrients · doi:10.3390/nu16172956 · Cited by 8
Prognostication in NAFLD: physiological bases, clinical indicators, and newer biomarkers
Terracciani, F., Falcomatà, A., Gallo, P., Picardi, A., & Gentilucci, U. V. (2022) · Journal of Physiology and Biochemistry · doi:10.1007/s13105-022-00934-0 · Cited by 9
“Furthermore, genetic predisposition and epigenetic modifications determine hepatic transcriptome dynamics [130] [131].”
BackgroundEpigenetic Network in Immunometabolic Disease
Geiger, M. A., Gorica, E., Mohammed, S. A., Mongelli, A., Mengozzi, A., Delfine, V., Ruschitzka, F. T., Costantino, S., & Paneni, F. (2023) · Advanced Biology · doi:10.1002/adbi.202300211 · Cited by 8
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“To understand the mechanism of disease progression, previous studies have investigated the transcriptome of liver biopsies from NAFLD patients at mild, medium, and severe stages.(17,18) However, the heterogeneities in different patients cannot reflect the temporal progression of the disease in a particular person.”
Backgroundα‐Lipoic Acid Increases Collagen Synthesis and Deposition in Nondiabetic and Diabetic Rat Kidneys
Grdović, N., Rajić, J., Јovanović, J. A., Dinić, S., Tolić, A., Đorđević, M., Đorđević, M., Trifunović, S. L., Vidaković, M., Uskoković, A. S., et al. (2021) · Oxidative Medicine and Cellular Longevity · doi:10.1155/2021/6669352 · Cited by 8
“Human methylome and transcriptome studies revealed correlation of Col4a1 promoter methylation with its expression in healthy and liver cells activated to produce ECM proteins [20, 48].”
BackgroundZeng, H.-L., Li, W., Xia, M.-F., Ge, J., Ma, H., Chen, L.-Y., Pan, B.-S., Lin, H., Wang, S., & Gao, X. (2024) · Lipids in Health and Disease · doi:10.1186/s12944-024-02304-9 · Cited by 9
Ye, H., Sun, M., Su, M., Chen, D., Liu, H., Ma, Y., Luo, W., Li, H., & Xu, F. (2023) · Frontiers in Genetics · doi:10.3389/fgene.2023.1070605 · Cited by 9
“The transcriptome of NAFLD patients has been profiled in several studies (Ahrens et al., 2013; Murphy et al., 2013; Arendt et al., 2015; Hoang et al., 2019; Azzu et al., 2021; Pantano et al., 2021).”
BackgroundLiu, Y., & Chen, M. (2023) · Current Issues in Molecular Biology · doi:10.3390/cimb45040237 · Cited by 7
Kurokawa, S., Kobori, T., Yoneda, M., Ogawa, Y., Honda, Y., Kessoku, T., Imajo, K., Saito, S., Nakajima, A., & Hotta, K. (2024) · BMC Gastroenterology · doi:10.1186/s12876-024-03149-3 · Cited by 7
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“Studies indicate that unique methylation patterns distinguish moderate from advanced MASLD [5,17].”
Alterations in the hepatocyte epigenetic landscape in steatosis
Maji, R. K., Czepukojc, B., Scherer, M., Tierling, S., Cadenas, C., Gianmoena, K., Gasparoni, N., Nordström, K. J. V., Gasparoni, G., Laggai, S., et al. (2023) · Epigenetics & Chromatin · doi:10.1186/s13072-023-00504-8 · Cited by 7
“Gianmoena K, et al. Epigenomic and transcriptional profiling identifies impaired glyoxylate detoxification in NAFLD as a risk factor for hyperoxaluria.”
BackgroundInfluentialLuo, Z., Yan, S., Chao, Y., & Shen, M. (2024) · Heliyon · doi:10.1016/j.heliyon.2024.e28935 · Cited by 6
“A total of 3 NAFLD-related datasets GSE49541[15], GSE89632[16] and GSE63067[17] were retrieved from the Gene Expression Omnibus (GEO) database [18] using the R package GEOquery [19].”
MethodEpigenetics in metabolic dysfunction-associated steatohepatitis
Zhang, Y., Ding, R., Hu, L., Liu, E., & Qu, P. (2025) · Cellular Signalling · doi:10.1016/j.cellsig.2025.111684 · Cited by 6
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“P300 and HDAC1 have been shown to be related to various liver diseases, such as nonalcoholic fatty liver disease (Murphy et al., 2013) and primary biliary cholangitis (X. Zhang et al., 2014).”
BackgroundLiver gene regulatory networks: Contributing factors to nonalcoholic fatty liver disease
Cebola, I. (2020) · WIREs Systems Biology and Medicine · doi:10.1002/wsbm.1480 · Cited by 5
“Global changes in DNA methylation and hydroxymethylation have also been implicated in NAFLD (Ahrens et al., 2013; Lyall et al., 2019; Murphy et al., 2013; Zeybel et al., 2015), and stronger DNA methyltransferase expression has been associated with NAFLD severity (Pirola et al., 2013).”
BackgroundLi, F., Ou, Q., Lai, Z., Pu, L., Chen, X., Wang, L., Sun, L., Liang, X., Wang, Y., Xu, H., et al. (2021) · Frontiers in Genetics · doi:10.3389/fgene.2021.671552 · Cited by 6
Zahoor, I., Mir, G. J., Lone, N. A., & Ashraf, N. U. (2025) · Journal of Obesity & Metabolic Syndrome · doi:10.7570/jomes24041 · Cited by 5
“115 This suggests that epigenetic alterations may mediate pathways that suppress autophagy in MASLD.”
The relationship between folic acid and nonalcoholic fatty liver disease
Xu, B., Yang, X., Zhu, X., Liu, Q., Zhang, Y., Zhang, M., Fan, C., Ban, X., Aikebaier, G., & Bian, H. (2024) · Clinical and Translational Discovery · doi:10.1002/ctd2.274 · Cited by 5
Chen, N., Luo, P., Tang, Y., Liu, P., Wang, J., Fan, Y., Han, L., & Wang, K. (2025) · Scientific Reports · doi:10.1038/s41598-025-93778-9 · Cited by 5
“Moreover, the dynamic characteristics of methylation make it a viable target for therapeutic intervention 17,33–35 .”
Metadata
- Authors
- Murphy, S. K., Yang, H., Moylan, C. A., Pang, H., Dellinger, A., Abdelmalek, M. F., Garrett, M. E., Ashley–Koch, A., Suzuki, A., Tillmann, H. L., Hauser, M. A., & Diehl, A. M.
- Affiliations
- Duke University (US)
- Corresponding author
- Diehl, Anna Mae
- ORCID
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 2013-11
- Volume
- 145
- Issue
- 5
- Pages
- 1076-1087
- ISSN
- 0016-5085 (ISSN-L)
- PMC
- PMC3805742
- OpenAlex
- W2150020322
- Cited by
- 391
- References
- 48
- Citations by year
- 2026: 14 · 2025: 23 · 2024: 36 · 2023: 37 · 2022: 31 · 2021: 35 · 2020: 31 · 2019: 38 · 2018: 40 · 2017: 32 · 2016: 26 · 2015: 28 · 2014: 17 · 2013: 2
- FWCI
- 10.89
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- The HKU Scholars Hub (University of Hong Kong) (submittedVersion)
- Funders
- National Institutes of Health (5rc2aa019399-02)
- National Institute on Alcohol Abuse and Alcoholism (5RC2-AA019399, RC2-AA019399)
- National Institute of Diabetes and Digestive and Kidney Diseases (T32DK007568)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Epigenetics and DNA Methylation
- Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Hepatology › Liver physiology and pathology
- Keywords
- non-alcoholic fatty liver disease, DNA methylation, transcriptome, liver fibrosis, disease severity, differentially methylated CpG sites, gene expression, FGF2, MAT1A, caspase-1, one-carbon metabolism, NAFLD progression, non-invasive diagnosis
- MeSH terms
- Adult, Biopsy, Diagnosis, Differential, Fatty Liver, Female, Gene Expression Regulation, Humans, Liver, Male, Methionine Adenosyltransferase, Middle Aged, Severity of Illness Index, Cohort Studies, Disease Progression, CpG Islands, DNA Methylation, Caspase 1, Receptor, Fibroblast Growth Factor, Type 2, Transcriptome, Non-alcoholic Fatty Liver Disease
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