Distinct changes in serum metabolites and lipid species in the onset and progression of NAFLD in Obese Chinese

The association between modified cardiometabolic index with non-alcoholic fatty liver disease and liver fibrosis: a cross-sectional study

BACKGROUND

Cardiometabolic index (CMI) was proposed ten years ago as an indicator combining obesity and dyslipidemia. This study aimed to investigate the relationships between newly modified CMI (MCMI) with non-alcoholic fatty liver disease (NAFLD) and liver fibrosis.

METHODS

This cross-sectional study included participants in the 2017-2018 National Health and Nutrition Examination Survey database (NHANES). Linear regression was used to explore the relationship between MCMI and Baseline characteristics. Logistic regression was conducted to analyze the correlation among MCMI with NAFLD and liver fibrosis. Furthermore, restricted cubic spline (RCS) was performed to estimate nonlinear relationships. Receiver operating characteristic curve (ROC) was used to assess the diagnostic performance of MCMI for NAFLD and liver fibrosis.

RESULTS

A total of 1385 participants were enrolled in the study. After adjusting covariates, participants with high MCMI were related to increased risk of NAFLD (OR = 3.52, 95%CI: 1.44-8.61), compared with those having low MCMI. A linear association was observed between MCMI and NAFLD (p for nonlinear = 0.074), and a J-shaped nonlinear relationship was found between MCMI and liver fibrosis (p for nonlinear = 0.002). The area under the curve (AUC) for MCMI to identify NAFLD was 0.821 (95% CI 0.799-0.843), which was higher than that of CMI (AUC = 0.761, 95%CI: 0.735-0.786), fatty liver index for the U.S. population (USFLI, AUC = 0.799, 95%CI: 0.776-0.822), Triglyceride glucose index (TyG, AUC = 0.738, 95%CI: 0.712-0.765), NAFLD liver fat score (NLFS, AUC = 0.786, 95%CI: 0.761-0.810) and hepatic steatosis index (HSI, AUC = 0.799, 95%CI: 0.775-0.822).

CONCLUSIONS

The novel MCMI was positively corelated to the risk of NAFLD. In addition, MCMI was an effective predictor for both NAFLD and liver fibrosis.

Altered liver lipidome markedly overlaps with human plasma lipids at diabetes risk and reveals adipose-liver interaction

Present study explores the role of liver lipidome in driving T2D-associated metabolic changes. Elevated liver triacylglycerols, reduced PUFAs, and 86 differentially abundant lipid species were identified in diabetes-prone mice. Of these altered lipid species, 82 markedly overlap with human plasma lipids associated with T2D/CVD risk. Pathway enrichment highlighted sphingolipid metabolism, however, only five of all genes involved in the pathway were differentially expressed in the liver. Interestingly, overlap with adipose tissue transcriptome was much higher (57 genes), pointing toward an active adipose-liver interaction. Next, the integration of liver lipidome and transcriptome identified strongly correlated lipid-gene networks highlighting ceramide [Cer(22:0)], dihydroceramide(24:1), and triacylglycerol(58:6) playing a central role in transcriptional regulation. Putative molecular targets of Cer(22:0) were altered (Cyp3a44, Tgf-β1) in primary mouse hepatocytes treated with Cer(22:0). Early alteration of liver lipidome markedly depends on adipose tissue expression pattern and provides substantial evidence linking early liver lipidome alterations and risk of T2D.

Identification of Diagnostic Biomarkers for Colorectal Polyps Based on Noninvasive Urinary Metabolite Screening and Construction of a Nomogram

PURPOSE/BACKGROUNDS

Colorectal polyps (CRPs) are precursors to colorectal cancer (CRC), and early detection is crucial for prevention. Traditional diagnostic methods are invasive, prompting a need for noninvasive biomarkers. This study aimed to identify urinary metabolite biomarkers for diagnosing CRPs and construct a diagnostic nomogram based on noninvasive urinary metabolite screening.

PATIENTS AND METHODS

A total of 192 participants, including 64 CRP patients and 128 healthy controls, were recruited. Urine samples were analyzed using untargeted gas chromatography-mass spectrometry (GC-MS) and ultra-performance liquid chromatography-mass spectrometry (UPLC-MS). Metabolite screening was performed using weighted gene coexpression network analysis (WGCNA), least absolute shrinkage and selection operator (LASSO), and support vector machine-recursive feature elimination (SVM-RFE). A diagnostic nomogram was developed based on identified metabolites, and its performance was evaluated using receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA).

RESULTS

A total of 350 metabolites were identified, with 7 key metabolites significantly associated with CRP. Multivariate logistic regression analysis identified Saccharin (OR = 48.3, 95% CI: 4.44-525.32) and N-omega-acetylhistamine (OR = 27.91, 95% CI: 2.31-337.06) as significant risk factors for CRP, while N-methyl-L-proline, trimethylsilyl ester (OR = 0.08, 95% CI: 0.01-0.8) was a protective factor. A nomogram incorporating these metabolites demonstrated strong discriminatory power, with AUC values of 0.974 and 0.960 in the training and validation sets, respectively. Calibration plots and DCA confirmed the model's accuracy and clinical utility.

CONCLUSIONS

This study successfully identified seven urinary metabolites as potential noninvasive biomarkers for CRP. The constructed diagnostic nomogram, based on these metabolites, offers high predictive accuracy and clinical applicability, providing a promising tool for the early detection of CRP.

Schematic Assessment of Metabolic Signatures of Non-alcoholic Fatty Liver Disease by Bridging Endocrinology and Internal Medicine: A Precision Therapy-Based Meta-Analysis

Non-alcoholic fatty liver disease (NAFLD) is seen as a health concern globally and is identified via complex interactions of metabolic dysfunctions. Metabolomic and lipidomic profiling has been emerged as a promising tool for non-invasive diagnosis and precision therapy. This systematic review and meta-analysis aimed to assess the affect of metabolic signatures associated with NAFLD progression and their utility in paving path for precision medicine. A comprehensive literature search was conducted in adherence to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020. Appropriate data studies were pooled to check the disease progression using a random effects model. Risk of bias and certainty of evidence were assessed using the Cochrane risk of bias tool, ROBINS-I ("Risk Of Bias In Non-randomized Studies - of Interventions"), and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework respectively. Studies found distinct metabolite patterns especially in amino acids, lipids, and gut-derived metabolites that correlated with the severity of NAFLD. The meta-analysis findings revealed a pooled hazard ratio of 0.98 (95% CI: 0.83-1.15) that indicated that no significant association was found between studies for assessment of metabolic signatures and their link to disease progression. High heterogeneity was observed (I² = 82%). Risk of bias was generally low to moderate, but overall certainty of evidence was rated low to moderate due to inconsistency and imprecision. Metabolic profiling offered valuable insights and discoveries into pathophysiology of NAFLD and stratification. However, high heterogeneity found across studies limited current clinical applicability. Standardized methodologies and longitudinal validation were needed to combine metabolic signatures into precision NAFLD care.

Untargeted lipidomic analysis of metabolic dysfunction-associated steatohepatitis in women with morbid obesity

Metabolic Dysfunction-Associated Steatohepatitis (MASH) represents the severe condition of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD). Currently, there is a need to identify non-invasive biomarkers for an accurate diagnosis of MASH. Previously, omics studies identified alterations in lipid metabolites involved in MASLD. However, these studies require validation in other cohorts. In this sense, our aim was to perform lipidomics to identify the circulating lipid metabolite profile of MASH. We assessed a liquid chromatography coupled to a mass spectrometer-based untargeted lipidomic assay in serum samples of 216 women with morbid obesity that were stratified according to their hepatic diagnosis into Normal Liver (NL, n =  44), Simple Steatosis (SS, n =  66) and MASH (n =  106). First, we identified a profile of lipid metabolites that are increased in MASLD, composed of ceramides, triacylglycerols (TAG) and some phospholipids. Then, we identified that patients with SS have a characteristic profile of increased levels of ceramides, diacylglycerols DG (36:2) and DG (36:4), some TAG and a few phospholipids such as PC (32:1), PE (38:3), PE (40:6), PI (32:0) and PI (32:1). Later, in MASH patients, we found increased levels of ceramides, deoxycholic acid, a set of TAG, and some phospholipids such as PC, PE, PI and LPI; while we found decreased levels of the DG (36:0). Finally, we have reported a panel of lipid metabolites that might be used to differentiate patients with MASH from SS patients, made up of increased levels of 9-HODE some PC and PE, the LPI (16:0) and decreased levels of DG (36:0). To conclude, our investigation has suggested a lipid metabolite profile associated with MASLD and MASH. Specifically, a set of lipid metabolites seems to be discriminatory in MASH subjects compared to SS individuals. Thus, this panel of lipid metabolites could be used as a non-invasive diagnostic tool.

PAMK Ameliorates Non-Alcoholic Steatohepatitis and Associated Anxiety/Depression-like Behaviors Through Restoring Gut Microbiota and Metabolites in Mice

OBJECTIVES

Long-term Western diet-induced non-alcoholic steatohepatitis (NASH) can lead to liver cirrhosis and NASH-associated hepatocellular carcinoma, which are end-stage liver diseases. Meanwhile, NASH is associated with mental burden and worsens as the disease progresses. Atractylodes Macrocephala Koidz (AMK) is one of the main ingredients of Shenling Baizhu San, and the effect of Polysaccharide from AMK ameliorates (PAMK), as an important medicinal ingredient of AMK, on NASH and associated anxiety/depression-like behaviors is still unclear.

METHODS

This study investigated the protective effect of PAMK on NASH and associated anxiety/depression-like behaviors through a Western diet-induced NASH mice model.

RESULTS

showed that PAMK decreased the concentrations of liver TC, TG, and serum AST and ALT, improving glucose tolerance, and reducing liver steatosis and fibrosis. Moreover, the expression of liver IL-6, IL-1β, TNF-α, IL-18 and MCP-1 could be reduced by PAMK significantly. Additionally, PAMK decreased anxiety/depression-like behaviors and expression of IL-6, IL-1β, TNF-α, and MCP-1 in the hippocampus. 16S rRNA gene sequencing revealed that PAMK diminished the Firmicutes/Bacteroidetes ratio and abundance of Faecalibaculum_rodentium, and increased the abundance of Muribaculaceae. This might be related to gene abundance of Pentose, the glucuronate interconversions pathway and carbohydrate enzymes (GH1, GH4). Serum metabolomics suggested that PC (18:5e/2:0), PC (16:2e/2:0), Lysopc 20:4, PC (16:0/2:0), and LPC 19:0 upregulated significantly after PAMK intervention, together with the enrichment of carbon metabolism and Citrate cycle pathways specially.

CONCLUSIONS

PAMK as a potential prebiotic ameliorated NASH and associated anxiety/depression-like behaviors in mice, probably by regulating Faecalibaculum_rodentium, carbohydrate enzymes and lipid metabolites.

The Interplay between Liver and Adipose Tissue in the Onset of Liver Diseases: Exploring the Role of Vitamin Deficiency

The deficiency of vitamins, a condition known as "hidden hunger", causes comprehensive pathological states. Research over the years has identified a relationship between liver diseases and hypovitaminosis or defects in vitamin metabolism. The exact mechanisms remain elusive; however, the crucial involvement of specific vitamins in metabolic functions, alongside the reclassification of liver disease as metabolic dysfunction-associated steatotic liver disease (MASLD), has prompted researchers to investigate the potential cause-effect dynamics between vitamin deficiency and liver disease. Moreover, scientists are increasingly investigating how the deficiency of vitamins might disrupt specific organ crosstalk, potentially contributing to liver disease. Although the concept of a dysmetabolic circuit linking adipose tissue and the liver, leading to liver disease, has been discussed, the possible involvement of vitamin deficiency in this axis is a relatively recent area of study, with numerous critical aspects yet to be fully understood. In this review, we examine research from 2019 to July 2024 focusing on the possible link between liver-adipose tissue crosstalk and vitamin deficiency involved in the onset and progression of non-alcoholic fatty liver disease (NAFLD). Studies report that vitamin deficiency can affect the liver-adipose tissue axis, mainly affecting the regulation of systemic energy balance and inflammation.

Serum Metabolomics Uncovers the Mechanisms of Inulin in Preventing Non-Alcoholic Fatty Liver Disease

Inulin may be a promising therapeutic molecule for treating non-alcoholic fatty liver disease (NAFLD). However, the underlying mechanisms of its therapeutic activity remain unclear. To address this issue, a high-fat-diet-induced NAFLD mouse model was developed and treated with inulin. The NAFLD phenotype was evaluated via histopathological analysis and biochemical parameters, including serum levels of alanine aminotransferase, aspartate aminotransferase, liver triglycerides, etc. A serum metabolomics study was conducted using ultra-performance liquid chromatography coupled with tandem mass spectrometry. The results revealed that inulin mitigated NAFLD symptoms such as histopathological changes and liver cholesterol levels. Through the serum metabolomics study, 347 differential metabolites were identified between the model and control groups, and 139 differential metabolites were identified between the inulin and model groups. Additionally, 48 differential metabolites (such as phosphatidylserine, dihomo-γ-linolenic acid, L-carnitine, and 13-HODE) were identified as candidate targets of inulin and subjected to pathway enrichment analysis. The results revealed that these 48 differential metabolites were enriched in several metabolic pathways such as fatty acid biosynthesis and cardiolipin biosynthesis. Taken together, our results suggest that inulin might attenuate NAFLD partially by modulating 48 differential metabolites and their correlated metabolic pathways, constituting information that might help us find novel therapies for NAFLD.