Astari Desi, Jasirwan Chyntia Olivia Maurine, Lesmana Cosmas Rinaldi Adithya, Simadibrata Marcellus, Kurniawan Juferdy, Yunihastuti Evy, Harimurti Kuntjoro, Nugroho Pringgodigdo
Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Hepatobiliary Division, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Acta Med Indones. 2025 Apr;57(2):167-174.
The current hypothesis regarding the mechanism of Non-Alcoholic Fatty Liver Disease (NAFLD) is the multiple hit theory, where one of the factors involved is gut microbiota. Short-chain fatty acid (SCFA) is the main metabolite of gut microbiota and is suspected to play a role in the development of NAFLD. This study aims to determine the correlation between SCFA levels (acetate, propionate, butyrate) and the degree of fibrosis and steatosis in patients with NAFLD assessed by controlled attenuation parameter (CAP) and transient elastography (TE).
A cross-sectional study that included 33 consecutively selected patients at Cipto Mangunkusumo Hospital was conducted from January to August 2023. Fecal sample collection was performed for SCFA examination using GC-MS (Gas Chromatography-Mass Spectrometry). Absolute fecal SCFAs were analyzed for correlation with steatosis and fibrosis based on controlled attenuation parameter (CAP) and transient elastography (TE) values.
Subjects were predominantly female (51.5%), with an average age of 49 years, an average CAP value of 296 dB/m, and a median transient elastography value of 6.1 kPa. The ratio of acetate, propionate, and butyrate values in the subjects was 59:24:17. A moderate negative correlation was observed between the absolute butyrate and CAP values (r=-0.522; p=0.002).
There is no correlation was identified between short-chain fatty acid levels and transient elastography values.
目前关于非酒精性脂肪性肝病（NAFLD）发病机制的假说是多重打击理论，其中涉及的一个因素是肠道微生物群。短链脂肪酸（SCFA）是肠道微生物群的主要代谢产物，被怀疑在NAFLD的发展中起作用。本研究旨在确定通过受控衰减参数（CAP）和瞬时弹性成像（TE）评估的NAFLD患者中SCFA水平（乙酸盐、丙酸盐、丁酸盐）与纤维化和脂肪变性程度之间的相关性。
2023年1月至8月在西托·曼古库苏莫医院进行了一项横断面研究，连续选取了33例患者。采集粪便样本，使用气相色谱 - 质谱联用仪（GC - MS）进行SCFA检测。基于受控衰减参数（CAP）和瞬时弹性成像（TE）值，分析粪便中SCFA的绝对含量与脂肪变性和纤维化的相关性。
受试者以女性为主（51.5%），平均年龄49岁，平均CAP值为296 dB/m，瞬时弹性成像值中位数为6.1 kPa。受试者中乙酸盐、丙酸盐和丁酸盐值的比例为59:24:17。观察到丁酸盐绝对含量与CAP值之间存在中度负相关（r = -0.522；p = 0.002）。
未发现短链脂肪酸水平与瞬时弹性成像值之间存在相关性
