Non-alcoholic fatty liver disease in patients with morbid obesity: the gut microbiota axis as a potential pathophysiology mechanism

Background/aim Alterations in gut microbiota are associated with the pathogenesis of metabolic diseases, including metabolic-associated fatty liver disease (MAFLD). The aim of this study was to evaluate gut microbiota composition and functionality in patients with morbid obesity with different degre...

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Published in:Journal of gastroenterology 2024-04, Vol.59 (4), p.329-341
Main Authors: Cornejo-Pareja, Isabel, Amiar, Mohamed Reda, Ocaña-Wilhelmi, Luís, Soler-Humanes, Rocío, Arranz-Salas, Isabel, Garrido-Sánchez, Lourdes, Gutiérrez-Repiso, Carolina, Tinahones, Francisco Jose
Format: Article
Language:English
Subjects:
Abdominal Surgery
Amino acids
Biliary Tract
Biopsy
Colorectal Surgery
Enterobacteriaceae
Ethanol
Fatty liver
Fermentation
Fibrosis
Gastroenterology
Gastrointestinal Microbiome
Gastrointestinal surgery
Hepatology
Humans
Intestinal microflora
Liver diseases
Medicine
Medicine & Public Health
Metabolic disorders
Metabolic pathways
Metabolism
Microbiomes
Microbiota
Non-alcoholic Fatty Liver Disease - diagnosis
Obesity
Obesity, Morbid - complications
Original Article―Liver
Original ―Liver, Pancreas, and Biliary Tract
Pancreas
Pathogenesis
Proteolysis
Ruminococcaceae
Steatosis
Succinates
Surgery
Surgical Oncology
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Summary:Background/aim Alterations in gut microbiota are associated with the pathogenesis of metabolic diseases, including metabolic-associated fatty liver disease (MAFLD). The aim of this study was to evaluate gut microbiota composition and functionality in patients with morbid obesity with different degrees of MAFLD, as assessed by biopsy. Subjects/methods 110 patients with morbid obesity were evaluated by biopsy obtained during bariatric surgery for MAFLD. Stool samples were collected prior to surgery for microbiota analysis. Results Gut microbiota from patients with steatosis and non-alcoholic steatohepatitis (NASH) were characterized by an enrichment in Enterobacteriaceae (an ethanol-producing bacteria), Acidaminococcus and Megasphaera and the depletion of Eggerthellaceae and Ruminococcaceae (SCFA-producing bacteria). MAFLD was also associated with enrichment of pathways related to proteinogenic amino acid degradation, succinate production, menaquinol-7 (K2-vitamin) biosynthesis, and saccharolytic and proteolytic fermentation. Basic histological hepatic alterations (steatosis, necroinflammatory activity, or fibrosis) were associated with specific changes in microbiota patterns. Overall, the core microbiome related to basic histological alterations in MAFLD showed an increase in Enterobacteriaceae and a decrease in Ruminococcaceae . Specifically, Escherichia coli was associated with steatosis and necroinflammatory activity, whilst Escherichia-shigella was associated with fibrosis and necroinflammatory activity. Conclusions We established a link between gut microbiota alterations and histological injury in liver diagnosis using biopsy. Harmful products such as ethanol or succinate may be involved in the pathogenesis and progression of MAFLD. Thus, these alterations in gut microbiota patterns and their possible metabolic pathways could add information to the classical predictors of MAFLD severity and suggest novel metabolic targets.
ISSN:0944-1174
1435-5922
DOI:10.1007/s00535-023-02075-7