One of the challenges of modern-day living is to resist the temptation of overfeeding and sedentariness and maintain a healthy body and mind. On a favorable genetic and epigenetic background, a high-fat diet combined with lack of physical exercise constitutes the foundation for severe metabolic disturbances including steatotic liver disease. In our case–control study, we had the aim of establishing the role of selected micro-RNAs—miR-122, miR-192, miR-33a, and miR-33b—as superior biomarkers for the diagnosis and prognosis of steatotic liver in a 36-patient cohort compared to 12 healthy controls. Initial results confirmed the decline in miR-122 expression as fatty liver is progressing. However, combinations of ΔmiRs, such as ΔmiR33a_192, ΔmiR33a_122, and ΔmiR33b_122, correlate with ultrasound steatosis grade (R² = 0.78) while others such as ΔmiR33b_122 provide a high specificity and sensitivity in fatty liver disease with an area under the curve (AUC) of 0.85. Compared to classical biomarkers, micro-RNAs can be used for both diagnostic and prognostic purposes as their diminished expression in severe cases of steatosis is associated with higher risk of emerging hepatocellular carcinoma. Manipulating micro-RNAs through agomirs or antagomirs can be the answer to the yet unsolved problem of efficient therapy in MAFLD.

[This corrects the article DOI: 10.3389/fendo.2024.1349524.].

Background and Objectives: Steatotic liver disease (SLD), formerly non-alcoholic liver disease, affects 25% of the global population, leading to significant morbidity and mortality. This study aims to explore the role of microRNAs (miRNAs) and epigenetic factors in SLD, focusing on their potential as biomarkers for diagnosing and understanding disease mechanisms, particularly in populations exposed to historical nutritional imbalances. Materials and Methods: We conducted a case-control study involving 48 patients diagnosed with liver steatosis, recruited from the Fundeni Clinical Institute. Plasma levels of miR-122, miR-192, miR-33a, and miR-33b were quantified using qRT-PCR. Statistical analyses included Pearson correlation, ANOVA, and t-tests to assess relationships between miRNA levels, age, and classical biomarkers. Results: All patients met at least one criterion for metabolic-associated steatotic liver disease (MASLD), with significant findings in miRNA expression. miR-122 levels were significantly lower, and miR-192 levels were significantly higher in high-risk groups compared to controls. Additionally, miR-33a levels were notably lower in the oldest age group. Correlations between miRNAs and classical biomarkers like Fib-4 were strong to moderate. Conclusions: The study confirms the potential of miRNAs as biomarkers for SLD, with miR-122, miR-192, and miR-33a showing significant associations with disease severity and patient age. These findings support the hypothesis that epigenetic mechanisms influenced by historical nutritional factors play a crucial role in SLD development. Future research should expand patient cohorts and explore therapeutic interventions targeting miRNA modulation.