Interplay of gut microbiota, glucagon-like peptide receptor agonists, and nutrition: New frontiers in metabolic dysfunction-associated steatotic liver disease therapy

World J Gastroenterol. 2024 Nov 21;30(43):4682-4688. doi: 10.3748/wjg.v30.i43.4682.

Abstract

The gut-liver axis plays a crucial role in the development and progression of metabolic dysfunction-associated steatotic liver disease (MASLD). Key metabolites, including lipopolysaccharides, short-chain fatty acids (SCFAs), bile acids, and beneficial gut bacteria such as Bifidobacterium and Lactobacillus, are pivotal in this process. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) show promise in managing MASLD by promoting weight loss, enhancing insulin secretion, and improving liver health. They restore gut-liver axis functionality, and their effects are amplified through dietary modifications and gut microbiome-targeted therapies. Emerging research highlights the interplay between GLP-1 RAs and gut microbiota, indicating that the gut microbiome significantly influences therapeutic outcomes. Metabolites produced by gut bacteria, can stimulate glucagon-like peptide-1 (GLP-1) secretion, further improving metabolic health. Integrating dietary interventions with GLP-1 RA treatment may enhance liver health by modulating the gut microbiota-SCFAs-GLP-1 pathway. Future research is needed to understand personalized effects, with prebiotics and probiotics offering treatment avenues for MASLD.

Keywords: Diet intervention; Glucagon-like peptide-1 receptor agonists; Gut microbiome; Gut-liver axis; Metabolic dysfunction-associated steatotic liver disease.

Publication types

  • Review

MeSH terms

  • Animals
  • Gastrointestinal Microbiome* / drug effects
  • Glucagon-Like Peptide 1 / agonists
  • Glucagon-Like Peptide 1 / metabolism
  • Glucagon-Like Peptide-1 Receptor* / agonists
  • Glucagon-Like Peptide-1 Receptor* / metabolism
  • Humans
  • Liver / drug effects
  • Liver / metabolism
  • Liver / pathology
  • Non-alcoholic Fatty Liver Disease / drug therapy
  • Non-alcoholic Fatty Liver Disease / metabolism
  • Non-alcoholic Fatty Liver Disease / microbiology
  • Prebiotics / administration & dosage
  • Probiotics / administration & dosage
  • Probiotics / therapeutic use

Substances

  • Glucagon-Like Peptide-1 Receptor
  • Glucagon-Like Peptide 1
  • Prebiotics