New determinants of liver steatosis and fibrosis in obese patients: results of a prospective clinical study
(2020) 2020 ESPEN Virtual Congress — Location: Lyon (France) (19.September.2020)
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- Authors
Thissen, Jean-Paul 
- Abstract
- Rationale: Obesity could lead to several metabolic alterations, including non-alcoholic fatty liver disease (NAFLD), muscle dysfunctions and gut dysbiosis. Here, we propose to evaluate the gut microbiota composition depending on the degree of NAFLD severity. Methods: Obese patients recruited prospectively at St-Luc Hospital (FOOD4GUT project, Belgium) were included in this study. Liver stiffness and controlled attenuation parameter (CAP) measurements were performed using liver transient elastography (TE). Physical examination, blood and stool samples and computed tomography (CT) were also assessed. The fecal gut microbiota was analyzed by Illumina sequencing of the 16S rRNA gene. Results: Liver TE allowed us to classify the patients in three groups based on CAP and stiffness measurement: LS (low steatosis, n=10), HS (high steatosis, n=18) and HS+F (high steatosis + fibrosis, n=9). CT data revealed significant muscle alterations in HS+F patients, with an increase of whole muscle area and a lower muscle density index compatible with muscle fat infiltration. Both α- and β- diversity indices of the overall gut microbiota composition were not different between groups. At the taxa level, only Clostridium sensu stricto significantly decreased with the severity of liver steatosis and fibrosis (p=0.018 for HS+F vs LS). However, an analysis based on amplicon sequence variants (ASV) revealed 20 bacterial sequences significantly affected. Spearman’s correlations showed that C. sensu stricto was negatively associated with liver fibrosis, the waist/hip ratio and muscle fat infiltration. Interestingly, many ASV also correlated with clinical outcomes. Conclusions: Liver steatosis and fibrosis severity associates with a set of markers including dysbiosis. Among them, C. sensu stricto decreased with the development of liver fibrosis and related muscle fat infiltration. Other bacterial ASV are pointed out as potential markers to be evaluated in larger cohorts to unravel their link with the degree of NAFLD related complication.
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Lanthier, N., Rodriguez, J., Nachit, M., Hiel, S., Trefois, P., Bindels, L., Neyrinck, A., Cani, P., Thissen, J.-P., & Delzenne, N. (2020). New determinants of liver steatosis and fibrosis in obese patients: results of a prospective clinical study. Clinical Nutrition ESPEN, 40, 438-439. https://doi.org/10.1016/j.clnesp.2020.09.104 (Original work published 2020)