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THE LINK BETWEEN GUT MICROBIOTA COMPOSITION, OBESITY, AND HEPATIC STEATOSIS/FIBROSIS IN THAI ADOLESCENTS: A CROSS-SECTIONAL STUDY

Peerada Suankaewmanee 1, Chomchanat Tubjareon 1, Jitrawee Shatthong 1, Sutha Eiamkulbutr 2, Sittichoke Prachuapthunyachart 1, Voranush Chongsrisawat 1

Affiliations

1 Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand

2 Excellence Center of Organ Transplant, King Chulalongkorn Memorial Hospital, Bangkok, Thailand

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Abstract

Introduction

Obesity and metabolic dysfunction-associated steatotic liver disease (MASLD) have been linked to gut dysbiosis.

Aims & Methods

This study aimed to investigate the relationship between gut microbiota composition, hepatic fat content and stiffness, and body mass index (BMI) status. This cross-sectional study enrolled adolescents aged 12 to 18. Transient elastography with controlled attenuation parameter (CAP) was employed to diagnose hepatic fibrosis and steatosis. Fecal samples were analyzed by 16S rRNA sequencing. Relative abundance, as well as alpha- and beta-diversity of the microbiota, were compared across participants with different nutrition statuses and the presence of hepatic steatosis and fibrosis.

Results

A total of 76 participants (51 males) were recruited for this study, including 43 with normal weight, 19 overweight, and 14 obese. The clinical characteristics of the participants are presented in Table 1. Hepatic steatosis was present in 8 out of 14 obese participants (57.2%) and 2 out of 19 overweight (10.5%) participants. Hepatic fibrosis was detected in 4 out of 14 obese participants (28.6%) but none in the normal weight or overweight groups. There were no significant differences in alpha- or beta-diversity between the normal weight, overweight, and obese groups. The Firmicutes to Bacteroidetes (F/B) ratio was 1.2 across all three groups. Several genera, including Eubacterium_halli_group and Ruminococcus_gauvreauii_group were present in higher abundances in the gut microbiome of the obese group compared to the normal-weight group, with p values of 0.025 and 0.036, respectively. In contrast, Bifidobacterium was more abundant in the normal-weight participants (p=0.012). Obese individuals with hepatic fibrosis exhibited a significantly higher F/B ratio compared to those without hepatic fibrosis (p=0.04). There were significant differences in the relative abundance of specific genera between the fibrosis and non-fibrosis groups: Phascolarctobacterium (p=0.020), Dorea (p=0.040), and Ruminococcus_gauvreauii_group (p=0.045) were present in higher abundances in the fibrosis group, whereas Senegalimassilia was more abundant in the non-fibrosis group (p=0.037).

	Normal (n=43)	Overweight and obesity (n=33)	P value
BMI Body mass index, CAP Controlled attenuation parameter Data expressed as number (percentage) or median (interquartile range) ^*P<0.05
Age (year)	14.4 (14.1-17.2)	15.2 (13.6-16.5)	0.71
CAP (decibels/meter)	186 (154-207)	203 (191-237.5)	<0.001^*
Presence of hepatic steatosis	0 (0.0%)	10 (30.4%)	<0.001^*
Liver stiffness (kilopascals)	3.9 (3.2-4.4)	4.9 (3.9-7.2)	0.025^*
Presence of hepatic fibrosis	0 (0.0%)	4 (12.0%)	0.032^*

Conclusion

Hepatic steatosis and fibrosis are common among obese adolescents. The gut microbiota abundance in obese individuals with hepatic fibrosis differ from those without it. Further studies are crucial to explore the role of gut microbiota modification in the progression of hepatic steatosis and fibrosis.

Conference

UEG Week Berlin 2025

Topics

Small Intestine & Nutrition

Submission format

Abstract

Session

NUTRITION (Posters)

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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Negative and inconclusive vs conclusive GERD	Endoscopy	Cut-off AET %	Sensitivity %	Specificity %	AUC	PPV %	NPV %
24 hr	Normal (n = 808)	6.4	100	99.6	1	98.9	100
	LA A (n = 61)	6	100	100	1	100	100
	LA B (n = 60)	8.7	73.8	94.4	0.89	96.8	60.7
48 hr	Normal (n = 808)	6.1	100	100	1	99.9	100
	LA A (n = 61)	6	100	100	1	100	100
	LA B (n = 60)	6.4	94.4	94.4	0.9	97.4	84.8

Country	Argentina (n=274)	Chile (n=343)	Colombia (n=200)	Costa Rica (n=104)	Ecuador (n=43)	Mexico (n=1,087)	Peru (n=446)	Overall (n=2,497)
Indication of Helicobacter pylori eradication								p<0.001*
Non-investigated dyspepsia	27 (9.9%)	45 (4.5%)	36 (18%)	2 (1.9%)	0 (0%)	700 (65%)	185 (42%)	995 (40%)
Dyspepsia with normal endoscopy	201 (74%)	202 (58%)	16 (8%)	15 (14%)	1 (2.3%)	33 (3%)	176 (39%)	644 (26%)
Duodenal Ulcer	13 (4.8%)	8 (2.3%)	5 (2.5%)	8 (7.7%)	1 (2.3%)	45 (4.1%)	9 (2%)	89 (3.6%)
Gastric Ulcer	13 (4.8%)	7 (5.1%)	13 (6.5%)	8 (7.7%)	7 (16%)	75 (6.9%)	14 (3.1%)	137 (5.5%)
Preneoplastic lesions	0 (0%)	2 (0.6%)	0 (0%)	19 (18%)	31 (67%)	67 (6.1%)	33 (7.4%)	152 (6.1%)
First-degree relatives of patients with gastric cancer	2 (0.7%)	12 (3.5%)	9 (4.5%)	10 (9.6%)	2 (4.7%)	19 (1.8%)	16 (3.6%)	70 (2.8%)
Screening to prevent gastric cancer	0 (0%)	0 (0%)	0 (0%)	1 (1%)	1 (2.3%)	17 (1.6%)	10 (2.2%)	29 (1.2%)
Other	6 (2.2%)	64 (19%)	109 (54%)	41 (39%)	0 (0%)	121 (11%)	2 (0.4%)	343 (14%)

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