Gut microbiota changes and novel markers associated with liver steatosis in obese patients

Background. Liver steatosis is a common condition that can progress to steatohepatitis, fibrosis, and cirrhosis and increases the risk of death from cardiovascular and liver complications. Understanding the link between steatosis and non-alcoholic fatty liver disease, obesity, and gut microbiota is essential. Recent studies have revealed that gut microbiota plays a crucial role in developing this condition, highlighting the importance of microbiota control. The purpose of the study was to detect changes in gut microbiota and new markers associated with hepatic steatosis in obese patients. Materials and methods. The study involved 60 men aged 38 to 65, divided into two groups: 32 patients with hepatic steatosis (experimental group) and 28 with no steatosis (controls). As part of the study, the levels of the lipogram were determined, anthropometric measurements were made, a bioimpedance analysis of the body was performed, as well as liver ultrasound and shear wave elastography. The gut microbiota of all participants was also examined using sequencing techno­logies (material collected from stool samples). Results. In the experimental group, there are significantly more patients with overweight, dyslipidemia (hypercholesterolemia, triglyceridemia, high low-density lipoproteins, high atherogenicity coefficient, and low high-density lipoproteins). Also, patients with hepatic steatosis are more likely to have an excessive percentage of fat and an excessive amount of visceral fat, hepatomegaly due to the craniocaudal size of the liver, and increased liver stiffness. Regarding the intestinal microbiota, there is an increase in bacterial groups belonging to the Bacteroidetes. Our analysis showed that specific markers such as body mass index, blood lipid profile, body fat percentage, and liver ultrasound parameters are essential for diagnosing steatosis. Body mass index above 24.9 kg/m2 and increased waist circumference were associated with steatosis. Bioimpedance analysis parameters, including body fat percentage and relative visceral fat level, were also crucial indicators. Dyslipidemia, with increased levels of total cholesterol, triglycerides, low-density lipoproteins, high atherogenicity coefficient, and lower high-density lipoproteins, was related to steatosis. The liver stiffness was significantly higher among patients with steatosis, indicating additional risk of liver fibrosis. Shear wave elastography can be a valuable tool for detecting liver steatosis. Conclusions. Patients with steatosis were characterized by signs of obesity (increased waist circumference, body mass index) and dyslipidemia, higher percentage of adipose tissue, relative amount of visceral fat, craniocaudal liver size, liver stiffness, and low levels of high-density lipoproteins. An increase in the gut microbiota of bacterial groups belonging to the Bacteroidetes has been observed.