Blood Endotoxin Levels as Biomarker of Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-analysis

Soppert, Josefin; Brandt, Elisa Fabiana; Heussen, Nicole; Barzakova, Emona; Blank, Lars M.; Kuepfer, Lars; Hornef, Mathias; Trebicka, Jonel; Jankowski, Joachim; Berres, Marie‐Luise; Noels, Heidi

doi:10.1016/j.cgh.2022.11.030

Cited by 17 publications

(15 citation statements)

References 62 publications

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“…[34] The results of this study confirm that blood LPS levels serve as a diagnostic biomarker for NAFLD, which can be used for disease detection, staging during disease progression, and as a substitute marker for enhanced intestinal permeability in NAFLD. [34] An imbalance in intestinal flora can lead to the destruction of gut barrier function and the development of NAFLD. And intestinal flora act a key role in regulating host immunity and metabolism.…”

Section: Spearman's Correlation Analysis Of Gut Microbiota Biochemica...supporting

confidence: 73%

“…A total of 34 studies were included in the study for meta‐analysis. The research results showed that the blood LPS levels in patients with simple steatosis were higher than those in the liver healthy control group (SMD=0.86, CI=0.62–1.11), and higher levels of LPS were observed in patients with higher histopathological grading of liver steatosis and fibrosis [34] . The results of this study confirm that blood LPS levels serve as a diagnostic biomarker for NAFLD, which can be used for disease detection, staging during disease progression, and as a substitute marker for enhanced intestinal permeability in NAFLD [34] …”

Section: Resultsmentioning

confidence: 89%

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Dendrobium huoshanense Polysaccharide Improves High‐Fat Diet Induced Liver Injury by Regulating the Gut‐Liver Axis

Ma,

Gao,

Chen

et al. 2023

Chemistry & Biodiversity

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Dendrobium huoshanense is an important Traditional Chinese medicine that thickens the stomach and intestines. Its active ingredient Dendrobium huoshanense polysaccharide (DHP), was revealed to relieve the symptoms of liver injury. However, its mechanism of action remains poorly understood. This study aimed to investigate the mechanism of DHP in protecting the liver. The effects of DHP on lipid levels, liver function, and intestinal barrier function were investigated in mice with high‐fat diet‐induced liver damage. Changes in the gut flora and their metabolites were analyzed using 16S rRNA sequencing and metabolomics. The results showed that DHP reduced lipid levels, liver injury, and intestinal permeability. DHP altered the intestinal flora structure and increased the relative abundance of Bifidobacterium animalis and Clostridium disporicum. Furthermore, fecal metabolomics revealed that DHP altered fecal metabolites and significantly increased levels of gut‐derived metabolites, spermidine, and indole, which have been reported to inhibit liver injury and improve lipid metabolism and the intestinal barrier. Correlation analysis showed that spermidine and indole levels were significantly negatively correlated with liver injury‐related parameters and positively correlated with the intestinal species B. animalis enriched by DHP. Overall, this study confirmed that DHP prevented liver injury by regulating intestinal microbiota dysbiosis and fecal metabolites.

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Section: Spearman's Correlation Analysis Of Gut Microbiota Biochemica...supporting

confidence: 73%

Section: Resultsmentioning

confidence: 89%

Dendrobium huoshanense Polysaccharide Improves High‐Fat Diet Induced Liver Injury by Regulating the Gut‐Liver Axis

Ma,

Gao,

Chen

et al. 2023

Chemistry & Biodiversity

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“…In addition, periodontal pathogens – mainly the Gram-negative anaerobic bacterium Porphyromonas gingivalis – are associated with leakage of endotoxin from the oral cavity into the bloodstream [27]. Notably, high levels of blood endotoxin have been related to more advanced grades of hepatic fibrosis in patients with NAFLD [28]. However, we cannot exclude that the occurrence of fatigue and physical frailty in patients with more advanced fibrosis stages may have impaired oral hygiene practices in our sample.…”

Section: Discussionmentioning

confidence: 99%

Can Frequent Toothbrushing Reduce the Risk of Cirrhosis among Patients with Nonalcoholic Fatty Liver Disease? Hints from a Registry-Based Study

Keklikkıran¹,

Stepanova²,

Younossi³

et al. 2023

Dig Dis

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Introduction: While poor oral hygiene has been previously associated with an increased risk of non-alcoholic fatty liver disease (NAFLD), its association with hepatic fibrosis remains unclear. Here, we sought to analyze if toothbrushing frequency, an easy-to-assess indicator of oral health habits, would be associated with liver stiffness measurement (LSM) by transient elastography (TE) in patients with an established diagnosis of NAFLD. Methods: In this registry-based study, LSM was measured in 1156 patients with NAFLD and analyzed in relation to the self-reported daily frequency of toothbrushing. LSM values ≥12 kPa were considered as indicative of cirrhosis. Results: A trend towards a stepwise decrease (cross-sectional p = 0.13) in LSM was found in patients who reported having their teeth brushed more frequently: less than once a day (10.6 ± 8.6 kPa; 13% of the study sample), once a day (9.95 ± 8.40 kPa; 40%), twice a day (9.21 ± 7.63 kPa; 43%), and after every meal (8.91 ± 5.30 kPa; 4%). Patients who brushed their teeth less than once a day had a significantly higher prevalence of LSM values ≥12 kPa (p < 0.05). In multivariable logistic regression analysis, the association of LSM values ≥ 12 kPa with toothbrushing habits remained statistically significant for less than once a day (odds ratio = 1.69, 95% confidence interval = 1.07−2.66, p = 0.02) with reference to twice a day or after every meal. Conclusion: Among patients with NAFLD, there is an independent association between brushing teeth less than once a day and TE-established cirrhosis.

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“…The lack of association between EndoCab and liver outcomes aligns with conclusions of a recent empirical study in similarly aged adolescents 14 and a 2022 systematic review and meta-analysis that reported elevations in circulating lipopolysaccharide and LBP among persons with hepatic steatosis and fibrosis but no consistent associations for EndoCab. 17 One explanation is low specificity of EndoCab as a marker of NAFLD, as this immunoglobulin can become elevated due to other common, unrelated conditions such as urinary tract infections and renal stones. 18 A second explanation is that the relationship of EndoCab with liver outcomes may be more readily detectable in populations with greater variation in cardiometabolic profile.…”

Section: Discussionmentioning

confidence: 99%

Endotoxin biomarkers, hepatic fat fraction, liver volume and liver stiffness among adolescents at high‐risk for non‐alcoholic fatty liver disease: The HEROES study

Perng,

Salmon,

Schenker

et al. 2023

Pediatric Obesity

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SummaryBackgroundNon‐alcoholic fatty liver disease (NAFLD) is on the rise among youth. Identifying biomarkers of NAFLD progression/risk can aid in prevention efforts.AimsThis pilot study investigated associations of two endotoxin biomarkers—lipopolysaccharide‐binding protein (LBP) and anti‐endotoxin core immunoglobulin G (EndoCab)—with markers of NAFLD among 99 Latino/Latina adolescents (11–19 years) with obesity.Materials & MethodsWe used linear regression to examine associations of each endotoxin biomarker (per 1‐SD) with hepatic fat fraction (HFF), liver volume, and liver stiffness.ResultsWe found positive associations of LBP with HFF and liver volume. Each 1‐SD increment in LBP corresponded with 2.35% (95% CI: 0.46%, 4.23%) higher HFF and 0.14 (0.06, 0.23) L greater liver volume after adjusting for age, sex, and maternal education. Accounting for abdominal adiposity and Tanner stage did not change results. Excluding 72 participants with NAFLD attenuated associations of LBP with HFF but associations with liver volume persisted (0.11 [0.01, 0.21] L). EndoCab was not associated with any liver outcomes. Neither endotoxin biomarker predicted liver stiffness.Discussion/conclusionWhile additional research is warranted, our results support LBP as a biomarker of NAFLD risk/progression in high‐risk youth.

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Blood Endotoxin Levels as Biomarker of Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-analysis

Cited by 17 publications

References 62 publications

Dendrobium huoshanense Polysaccharide Improves High‐Fat Diet Induced Liver Injury by Regulating the Gut‐Liver Axis

Dendrobium huoshanense Polysaccharide Improves High‐Fat Diet Induced Liver Injury by Regulating the Gut‐Liver Axis

Can Frequent Toothbrushing Reduce the Risk of Cirrhosis among Patients with Nonalcoholic Fatty Liver Disease? Hints from a Registry-Based Study

Endotoxin biomarkers, hepatic fat fraction, liver volume and liver stiffness among adolescents at high‐risk for non‐alcoholic fatty liver disease: The HEROES study

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