Abstract
The aim of the present study is to explore the frequency of small intestinal bacterial overgrowth (SIBO) and orocecal transit time (OCTT) in patients with nonalcoholic fatty liver disease (NAFLD). 103 patients with NAFLD and 49 healthy controls were enrolled. Clinical indicators such as BMI, liver function, blood lipids, homeostasis model assessment-insulin resistance (HOMA-IR), serum endotoxin of NAFLD patients were collected and examined. FibroTouch was used to detect the controlled attenuation parameter (CAP) and liver stiffness measurement (LSM). SIBO and OCTT were measured by the lactulose hydrogen breath test. The incidence of SIBO in NAFLD patients (58.3%) was significantly higher than that in healthy controls (26.5%). The level of serum endotoxin in NAFLD patients was higher than that in healthy controls. The levels of CAP, LSM, serum endotoxin, alanine transaminase, asperate aminotransferase and HOMA-IR in SBIO-positive NAFLD patients were higher than those in SIBO-negative patients. There was no significant difference in glutamyl transpeptidase triglyceride, low density lipoprotein and BMI between the two groups. OCTT in NAFLD patients was longer than that in healthy controls. It was also observed that OCTT in SIBO-positive NAFLD patients was significantly delayed compared with SIBO-negative NAFLD patients. Patients with NAFLD exhibit the increased incidence rate of SIBO and prolonged OCTT; SIBO in NAFLD patients maybe a contributing factor to the elevated transaminase, hepatic steatosis, progression of liver fibrosis and prolonged OCTT.
Highlights
To explore the frequency of small intestinal bacterial overgrowth (SIBO) and orocecal transit time (OCTT) in patients with nonalcoholic fatty liver disease (NAFLD)
Nonalcoholic fatty liver disease (NAFILD) is a group of metabolic liver diseases closely related to genetic factors and insulin resistance, the pathology of which is mainly manifested by diffuse hepatic macrovesicular steatosis
The NAFLD was diagnosed based on the criteria recommended by Guidelines for the Diagnosis and Treatment of Nonalcoholic Fatty Liver Diseases formulated by Fatty Liver and Alcoholic Liver Disease Study Group of the Chinese Liver Disease Association: imaging examination consistent with the performance of diffuse fatty liver; no alcoholic history or alcohol intake less than 140 g/week of ethanol; exclusion of specific hepatic diseases that can cause hepatic steatosis, such as viral hepatitis, drug-induced liver damage, autoimmune liver disease, and hepatolenticular degeneration, etc
Summary
To explore the frequency of small intestinal bacterial overgrowth (SIBO) and orocecal transit time (OCTT) in patients with nonalcoholic fatty liver disease (NAFLD). Methods: 103 patients with NAFLD and 49 healthy controls were enrolled Clinical indicators such as body mass index (BMI), liver function, blood lipids, HOMA-IR, serum endotoxin of NAFLD patients were collected and examined. The level of serum endotoxin in NAFLD patients was higher than that in healthy controls. Conclusions: Patients with NAFLD exhibit the increased incidence rate of SIBO and prolonged OCTT; SIBO in NAFLD patients is a contributing factor to the elevated transaminase, hepatic steatosis, progression of liver fibrosis and prolonged OCTT. Lactulose hydrogen breath test is a sensitive, convenient and non-invasive test for the diagnosis of small intestinal bacterial overgrowth (SIBO) and for the evaluation of orocecal transit time (OCTT). This study is intended to clarify the effects of SIBO on various clinical indicators of patients with NAFLD, providing new clues to reveal the pathogenesis of NAFLD and offering evidence for its prevention and treatment
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