Objectives Nonalcoholic steatohepatitis (NASH) can progress to advanced fibrosis; the link between intestinal bacterial overgrowth and NASH has been proposed. Gut microbiota may promote inflammation and provoke disease progression. We evaluated gut microbiota pattern in NASH and its influencing factors. Methods A case-controlled study with sixteen NASH and eight control subjects was done. We performed DNA extraction from stool samples and bacterial 16S rRNA sequencing using MiSeq™. The sequences were clustered into operational taxonomic units using Quantitative Insights Into Microbial Ecology software. We calculated relative abundances, determined alpha diversity, obtained beta diversity by principal coordinate analysis, and conducted the partial least-squares regression model. Results The relative abundance of Bacteroidetes tended to be higher in NASH group. The Bacteroidetes/Firmicutes (B/F) ratio was significantly elevated in NASH patients. The pattern of gut microbiota in NASH was clearly separated from that of control subjects. Factors influencing the separation of NASH from control subjects were age, diabetes, body mass index, Bacteroidetes phylum, metformin, Actinobacteria, Verrucomicrobia, Thermotogae, and Caldithrix and Bacteroidetes/Firmicutes ratio. Conclusions Bacteroidetes phylum (Bacteroides and Prevotella genus) is abundant in NASH subjects, who exhibited an elevated B/F ratio. NASH patients showed a specific pattern of gut microbiota independent of diabetes or metformin use.

Background. An increased prevalence of metabolic syndrome including nonalcoholic fatty liver disease (NAFLD) was reported in psoriasis. NAFLD can progress to nonalcoholic steatohepatitis and fibrosis. Transient elastography (TE) is a noninvasive liver fibrosis assessment. We evaluated the prevalence of significant liver fibrosis or high liver stiffness measurement (LSM) using the LSM cutoff over 7 kPa and its associated factors in psoriatic patients. Methods. Subjects underwent TE and ultrasonography. Univariate and multivariate analysis were performed for the associated factors. Results. One hundred and sixty-eight patients were recruited. Three patients were excluded due to TE failure. Mean BMI was 24.8 ± 4.7 kg/m2. NAFLD, metabolic syndrome, and diabetes were seen in 105 (63.6%), 83 (50.3%), and 31 (18.8%) patients. The total cumulative dose of methotrexate over 1.5 g was seen in 39 (23.6%) patients. Mean LSM was 5.3 ± 2.9 kPa. High LSM was found in 18 (11.0%) patients. Waist circumference (OR: 1.24; 95% CI: 1.11–1.38; P = 0.0002), diabetes (OR: 12.70; 95% CI: 1.84–87.70; P = 0.010), and AST (OR: 1.08; 95% CI: 1.02–1.16; P = 0.017) were associated with high LSM. Conclusion. 11% of psoriatic patients had significant liver fibrosis by high LSM. Waist circumference, diabetes, and AST level were the independent predictors.

BackgroundControlled attenuation parameter (CAP) and liver stiffness (LS) measured by transient elastography (TE, Fibroscan®) have been used for steatosis and fibrosis assessment. We evaluated the effect of meal intake on CAP and LS values.MethodsForty patients who had had a liver biopsy within the previous month were recruited. The biopsy was graded for fibrosis (F) and steatosis (S) stagings. TE was performed after overnight fasting (baseline values) and 15, 30, 45, 60, 90, and 120 min following the intake of a standard commercial formula meal, and every 30 min until LS and CAP values returned to baseline. The effect of meal intake on CAP and LS values was analyzed with a multilevel mixed model approach. ResultsThe mean age was 53.1 ± 11.2 years old. The mean (SD) BMI was 25.6 ± 4.5 kg/m2. F0, F1, F2, F3 and F4 fibrosis stages were found in 17 (42.5%), 9 (22.5%), 4 (10.0%), 8 (20.0%) and 2 (5.0%), respectively. S0, S1, S2 and S3 steatosis stages were seen in 22 (55.0%), 11 (27.5%), 4 (10.0%) and 3 (7.5%), respectively. The mean (SD) CAP and median (IQR) LS values at baseline were 249.7 ± 58.1 dB/m and 11.9 (6–18.1) kPa. A significant decrease in CAP values was observed in all patients 15 to 120 min after meals, with the CAP peak value at 60 min and the mean post-meal delta reduction of 18.1 dB/min. CAP values declined after meals at early fibrosis stages and across all stages of steatosis. A significant increase in LS values after meal intake was observed within 15 to 120 min, with the LS peak value at 15 min and the mean post-meal delta increase of 2.4 kPa. Post-meal CAP and LS values returned to baseline within 150 min following meals.ConclusionFollowing a meal, patients’ CAP values declined with the peak value at 60 min, contrasting with the rising of LS values with the peak value at 15 min. The post-meal CAP and LS values returned to baseline by 150 min. A fasting period of more than 150 min after a meal is recommended for patients undergoing TE.