Chen T, Zhou K, Sun T, et al. - This study offers new biomarkers and tools for the monitoring of liver disease progression and also unveiled stage-specific bile acid (BA) perturbation patterns.

• According to emerging evidence, the structure of conjugated BAs is associated with chronic liver disease (CLD) progression.

• This study involved 1883 individuals including healthy controls and CLD patients (NAFL, NASH, fibrosis, cirrhosis, and 3 types of liver cancer) in whom 15 BAs were quantified.

• On calculating five BA glycine:taurine ratios, GCA/TCA, GDCA/TDCA, and GCDCA/TCDCA, were revealed as candidates.

• Development of three diagnostic models was accomplished for distinguishing healthy control and early CLD (NAFL+NASH), early and advanced CLD (fibrosis+cirrhosis+liver cancer), and NAFL and NASH respectively.

• Models offered auROCs ranging from 0.91 to 0.97, and model performances were further improved by adding age and gender.

• Independent test sets (n=291) successfully validated alterations of the candidates and the performances of the diagnostic models.