Association between HBV genotype, HBeAg status and viral load.

<p>GT, genotype; HBV DNA, hepatitis B viral DNA; HBeAg, hepatitis B e antigen</p><p>Association between HBV genotype, HBeAg status and viral load.</p

HBeAg status in the four age cohorts.

<p>HBeAg status in the four age cohorts.</p

Bile Acids and Dysbiosis in Non-Alcoholic Fatty Liver Disease

<div><p>Background & Aims</p><p>Non-alcoholic fatty liver disease (NAFLD) is characterized by dysbiosis. The bidirectional effects between intestinal microbiota (IM) and bile acids (BA) suggest that dysbiosis may be accompanied by an altered bile acid (BA) homeostasis, which in turn can contribute to the metabolic dysregulation seen in NAFLD. This study sought to examine BA homeostasis in patients with NAFLD and to relate that with IM data.</p><p>Methods</p><p>This was a prospective, cross-sectional study of adults with biopsy-confirmed NAFLD (non-alcoholic fatty liver: NAFL or non-alcoholic steatohepatitis: NASH) and healthy controls (HC). Clinical and laboratory data, stool samples and 7-day food records were collected. Fecal BA profiles, serum markers of BA synthesis 7-alpha-hydroxy-4-cholesten-3-one (C4) and intestinal BA signalling, as well as IM composition were assessed.</p><p>Results</p><p>53 subjects were included: 25 HC, 12 NAFL and 16 NASH. Levels of total fecal BA, cholic acid (CA), chenodeoxycholic acid (CDCA) and BA synthesis were higher in patients with NASH compared to HC (<i>p</i><0.05 for all comparisons). The primary to secondary BA ratio was higher in NASH compared to HC (<i>p =</i> 0.004), but ratio of conjugated to unconjugated BAs was not different between the groups. Bacteroidetes and <i>Clostridium leptum</i> counts were decreased in in a subset of 16 patients with NASH compared to 25 HC, after adjusting for body mass index and weight-adjusted calorie intake (<i>p</i> = 0.028 and <i>p</i> = 0.030, respectively). <i>C</i>. <i>leptum</i> was positively correlated with fecal unconjugated lithocholic acid (LCA) (<i>r</i> = 0.526, <i>p</i> = 0.003) and inversely with unconjugated CA (<i>r</i> = -0.669, <i>p</i><0.0001) and unconjugated CDCA (<i>r</i> = - 0.630, <i>p</i><0.0001). FGF19 levels were not different between the groups (<i>p</i> = 0.114).</p><p>Conclusions</p><p>In adults with NAFLD, dysbiosis is associated with altered BA homeostasis, which renders them at increased risk of hepatic injury.</p></div

Serum FGF19 in the study population (<i>n</i> = 46).

<p>Serum FGF19 in the study population (<i>n</i> = 46).</p

Conjugated primary and secondary bile acid distribution in the study population (<i>n</i> = 53).

<p>Conjugated primary and secondary bile acid distribution in the study population (<i>n</i> = 53).</p

Demographic and laboratory results.

<p>Demographic and laboratory results.</p

Correlations with fecal unconjugated primary bile acids.

<p>(A) Correlation of fecal unconjugated primary bile acids and NAS (p < 0.001, r = 0.528). (B) Correlation of fecal unconjugated primary bile acids and plasma ALT (p < 0.001, r = 0.531). (C) Correlation of fecal unconjugated primary bile acids and serum triglycerides (p = 0.021, r = 0.338).</p

Serum C4 in the study population (<i>n</i> = 48).

<p>Serum C4 in the study population (<i>n</i> = 48).</p

Changes in fecal bile acid composition in HC, NAFL and NASH patients.

<p>Changes in fecal bile acid composition in HC, NAFL and NASH patients.</p

Serum C4 and FGF19 levels in HC, NAFL and NASH groups.

<p>(A) Serum C4 levels in HC, NAFL and NASH (<i>n</i> = 48) *<i>p</i> < 0.05 compared to HC. (B) Serum fibroblast growth factor 19 (FGF19) levels in HC, NAFL and NASH (<i>n</i> = 46).</p