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Bacteroidetes less prominent in intestinal microbiota of patients with NASH

The presence of nonalcoholic steatohepatitis is independently associated with a lower percentage of Bacteroidetes in the intestinal microbiota, according to recent results.

In a prospective, cross-sectional study, researchers evaluated bacterial counts of Bacteroides/Prevotella, Clostridium leptum, Clostridium coccoides, Escherichia coli, bifidobacteria and archaea in stool samples collected from 50 adult patients. The cohort included 11 patients with simple steatosis (SS) and 22 with nonalcoholic steatohepatitis (NASH), along with 17 healthy controls under evaluation for live liver donation. Clinical and laboratory data were assessed, and patients provided 7-day food intake and activity logs recorded before undergoing liver biopsy among patients with nonalcoholic fatty liver disease (NAFLD), or liver donation among controls.

Bacteroidetes made up a smaller percentage of the intestinal microbiota (IM) among patients with NASH compared with controls and patients with SS (P=.006). Those with NASH also had a higher percentage of C. coccoides in their total bacterial counts than patients with SS (P=.04). Investigators observed no other differences in evaluated bacteria. Adjustment for BMI and dietary fat intake rendered the difference in C. coccoides nonsignificant between the SS and NASH groups, but the association between NASH and lower Bacteroidetes concentrations remained (P=.002).

Investigators observed no correlations between caloric intake or fat or carbohydrate consumption and the presence of any evaluated bacteria. When analysis was restricted to only those with SS and NASH, a negative association was observed between daily caloric intake and Bacteroidetes counts (r=–0.43; P=.038).

“To our knowledge, this is the first study assessing the IM of adults with nonexperimental NAFLD, and specifically comparing the IM composition of subjects classified as [controls], SS or NASH based on histological data,” the researchers wrote. “We found a lower relative abundance of Bacteroidetes in NASH, which was independent of BMI and energy intake from fat in the diet.

“Future research should address this topic, considering that the IM may serve as a potential therapeutic target in NASH, which is currently primarily managed by recommending weight loss and increased physical activity, which are notoriously difficult to sustain.”