S Guercio Nuzio1, M Di Stasi1, L Pierri1, J Troisi1,2, M Poeta1, A Bisogno1, F Belmonte1, M Tripodi1, D Di Salvio1, G Massa1, R Savastano1, P Cavallo3, M Boffardi4, D Ziegenhardt5, I Bergheim5, C Mandato6, P Vajro1,7,8. 1. Pediatrics, Department of Medicine and Surgery, University of Salerno, Baronissi, Italy. 2. Laboratory of Metabolomics Theoreo, Pugliano, Italy. 3. Department of Physics, University of Salerno, Fisciano, Italy. 4. Laboratory, Section of Cava dei Tirreni, AOU Salerno, Salerno, Italy. 5. Institute of Nutritional Sciences, SD Model Systems of Molecular Nutrition, Friedrich-Schiller-University Jena, Jena, Germany. 6. Department of Pediatrics, AORN Santobono - Pausilipon, Naples, Italy. 7. European Laboratory for Food Induced Intestinal Disease (ELFID), Naples, Italy. 8. 8 AOU San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy.
Abstract
BACKGROUND: Gut-liver axis (GLA) dysfunction appears to play a role in obesity and obesity-related hepatic complications. OBJECTIVES: This study sought to concurrently explore several GLA components in a paediatric obese population with/without liver disease. METHODS: Thirty-two children (mean age 11.2 years) were enrolled: nine controls with normal weight and 23 patients with obesity (OB+). Of the 23 patients OB(+), 12 had not steatosis (ST-), and 11 had steatosis (ST+) (associated [n = 8] or not [n = 3] with hypertransaminasaemia [ALT +/-]). Subjects were characterized by using auxologic, ultrasonographic and laboratory parameters. A glucose hydrogen breath test was performed to test for small intestinal bacterial overgrowth, a urinary lactulose/mannitol ratio (LMR) was obtained to assess intestinal permeability, and tests for transaminases, blood endogenous ethanol, endotoxin and faecal calprotectin were also conducted. RESULTS: Eleven out of 23 patients OB(+) (p < 0.05) exhibited pathological (>90th percentile of the control group values) LMR, with values paralleling the grade of liver involvement (normal weight < OB[+] < OB[+]ST[+]ALT[-] < OB[+)]ST[+]ALT[+] [p < 0.05]). LMR significantly correlated with ethanolaemia (r = 0.38, p = 0.05) and endotoxaemia (r = 0.48, p = 0.015) concentrations. Increased permeability was a risk factor for the development of steatosis (p < 0.002). SIBO was present only in patients with obesity. Faecal calprotectin concentrations were within normal limits in all subjects. CONCLUSIONS: Increased permeability, endogenous ethanol and systemic endotoxin concentrations reflect some GLA dysfunction in obesity and its hepatic complications. Pending further results to establish their potential causative roles, the modulation of the GLA appears to represent a possible target for the prevention and treatment of these conditions.
BACKGROUND: Gut-liver axis (GLA) dysfunction appears to play a role in obesity and obesity-related hepatic complications. OBJECTIVES: This study sought to concurrently explore several GLA components in a paediatric obese population with/without liver disease. METHODS: Thirty-two children (mean age 11.2 years) were enrolled: nine controls with normal weight and 23 patients with obesity (OB+). Of the 23 patientsOB(+), 12 had not steatosis (ST-), and 11 had steatosis (ST+) (associated [n = 8] or not [n = 3] with hypertransaminasaemia [ALT +/-]). Subjects were characterized by using auxologic, ultrasonographic and laboratory parameters. A glucosehydrogen breath test was performed to test for small intestinal bacterial overgrowth, a urinary lactulose/mannitol ratio (LMR) was obtained to assess intestinal permeability, and tests for transaminases, blood endogenous ethanol, endotoxin and faecal calprotectin were also conducted. RESULTS: Eleven out of 23 patientsOB(+) (p < 0.05) exhibited pathological (>90th percentile of the control group values) LMR, with values paralleling the grade of liver involvement (normal weight < OB[+] < OB[+]ST[+]ALT[-] < OB[+)]ST[+]ALT[+] [p < 0.05]). LMR significantly correlated with ethanolaemia (r = 0.38, p = 0.05) and endotoxaemia (r = 0.48, p = 0.015) concentrations. Increased permeability was a risk factor for the development of steatosis (p < 0.002). SIBO was present only in patients with obesity. Faecal calprotectin concentrations were within normal limits in all subjects. CONCLUSIONS: Increased permeability, endogenous ethanol and systemic endotoxin concentrations reflect some GLA dysfunction in obesity and its hepatic complications. Pending further results to establish their potential causative roles, the modulation of the GLA appears to represent a possible target for the prevention and treatment of these conditions.
Authors: Monika Rau; Ateequr Rehman; Marcus Dittrich; Albert K Groen; Heike M Hermanns; Florian Seyfried; Niklas Beyersdorf; Thomas Dandekar; Philip Rosenstiel; Andreas Geier Journal: United European Gastroenterol J Date: 2018-09-30 Impact factor: 4.623
Authors: Dmitry O Ivanov; Inna I Evsyukova; Gianluigi Mazzoccoli; George Anderson; Victoria O Polyakova; Igor M Kvetnoy; Annalucia Carbone; Ruslan A Nasyrov Journal: Biology (Basel) Date: 2020-04-05