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Low Serum sRAGE and MASLD Are Associated and Share a Similar Gut Microbiota Profile: A Prospective and
Laura Sol Grinshpan1,2, Dana Ivancovsky-Wajcman1,2, Oren Tirosh3
1School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
Background/Aims:
The pathogenesis of metabolic dysfunction-associated steatotic liver disease (MASLD) is multifactorial, with evidence suggesting a protective role for the soluble receptor for advanced glycation end-products (sRAGE). While gut microbiota dysbiosis and MASLD have been linked, evidence of their association with sRAGE remains limited. We aimed to test the prospective association between serum sRAGE levels and MASLD and to explore associated patterns of gut microbiota composition.
Methods:
A prospective cohort study assessed serum sRAGE levels and MASLD at two time points, with new-onset or persistence of MASLD evaluated by ultrasonography or controlled attenuation parameter. A cross-sectional analysis was performed on a sub-sample with gut microbiota measurements using 16S rRNA sequencing (V3-V4, Illumina MiSeq).
Results:
Among 289 subjects in the prospective analysis (mean follow-up: 6.67 ± 0.73 years, mean age: 58.54 ± 6.54 years, 57.8% men), low sRAGE levels were associated with 2.22-fold greater odds of new-onset/persistent MASLD (95% CI 1.15-4.26, p = 0.017), with a dose-response association across sRAGE tertiles. The cross-sectional analysis with a subsample of 136 subjects showed significant α- and β-diversity differences between MASLD and non-MASLD groups. Moreover, β-diversity variation across sRAGE groups resembled that observed between the MASLD groups. Shared taxa linked to low sRAGE levels and MASLD included Streptococcaceae, Enterobacteriaceae, Streptococcus, Dorea, and Klebsiella. Non-MASLD and high sRAGE levels were associated with Christensenellaceae, Akkermansiaceae, Christensenellaceae R-7 group and Akkermansia.
Conclusions:
Low sRAGE levels are associated with higher odds of MASLD. MASLD and low sRAGE levels share a similar gut microbiota signature, suggesting a potential biological link that warrants further investigation.
Insights
Low levels of soluble receptor for advanced glycation end-products (sRAGE) increase the risk of developing metabolic dysfunction-associated steatotic liver disease (MASLD). Both MASLD and low sRAGE share similar gut microbiota profiles, suggesting a potential biological connection.
Area of Science:
- Hepatology
- Metabolic Diseases
- Microbiome Research
Background:
- Metabolic dysfunction-associated steatotic liver disease (MASLD) pathogenesis is complex.
- The soluble receptor for advanced glycation end-products (sRAGE) may have a protective role.
- The link between gut microbiota, MASLD, and sRAGE requires further elucidation.
Purpose of the Study:
- To prospectively assess the association between serum sRAGE levels and MASLD.
- To investigate the relationship between sRAGE levels and gut microbiota composition in MASLD.
Main Methods:
- Prospective cohort study evaluating serum sRAGE and MASLD over time.
- MASLD diagnosis confirmed via ultrasonography or controlled attenuation parameter.
- Gut microbiota analyzed using 16S rRNA sequencing in a sub-sample.
Main Results:
- Low sRAGE levels were linked to a 2.22-fold increased risk of new-onset or persistent MASLD.
- A dose-response relationship was observed between sRAGE levels and MASLD risk.
- Significant differences in gut microbiota diversity were found between MASLD and non-MASLD groups, with shared taxa linked to low sRAGE and MASLD.
Conclusions:
- Reduced serum sRAGE levels are associated with a higher likelihood of MASLD.
- MASLD and low sRAGE share a common gut microbiota signature.
- These findings suggest a potential biological link between sRAGE, gut microbiota, and MASLD pathogenesis.
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