{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:42:49Z","timestamp":1790775769895,"version":"4.1.0"},"reference-count":51,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T00:00:00Z","timestamp":1707868800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>Bacterial species and microbial pathways along with metabolites and clinical parameters may interact to contribute to non\u2010alcoholic fatty liver disease (NAFLD) and disease severity. We used integrated machine learning models and a cross\u2010validation approach to assess this interaction in bariatric patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>113 patients undergoing bariatric surgery had clinical and biochemical parameters, blood and stool metabolite measurements as well as faecal shotgun metagenome sequencing to profile the intestinal microbiome. Liver histology was classified as normal liver obese (NLO; <jats:italic>n<\/jats:italic>\u2009=\u200930), simple steatosis (SS; <jats:italic>n<\/jats:italic>\u2009=\u200941) or non\u2010alcoholic steatohepatitis (NASH; <jats:italic>n<\/jats:italic>\u2009=\u200942); fibrosis was graded F0 to F4.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found that those with NASH versus NLO had an increase in potentially harmful <jats:italic>E. coli<\/jats:italic>, a reduction of potentially beneficial <jats:italic>Alistipes putredinis<\/jats:italic> and an increase in ALT and AST. There was higher serum glucose, faecal 3\u2010(3\u2010hydroxyphenyl)\u20103\u2010hydroxypropionic acid and faecal cholic acid and lower serum glycerophospholipids. In NAFLD, those with severe fibrosis (F3\u2013F4) versus F0 had lower abundance of anti\u2010inflammatory species (<jats:italic>Eubacterium ventriosum<\/jats:italic>, <jats:italic>Alistipes finegoldii<\/jats:italic> and <jats:italic>Bacteroides dorei<\/jats:italic>) and higher AST, serum glucose, faecal acylcarnitines, serum isoleucine and homocysteine as well as lower serum glycerophospholipids. Pathways involved with amino acid biosynthesis and degradation were significantly more represented in those with NASH compared to NLO, with severe fibrosis having an overall stronger significant association with Superpathway of menaquinol\u201010 biosynthesis and Peptidoglycan biosynthesis IV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In bariatric patients, NASH and severe fibrosis were associated with specific bacterial species, metabolic pathways and metabolites that may contribute to NAFLD pathogenesis and disease severity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.15864","type":"journal-article","created":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T09:10:39Z","timestamp":1707901839000},"page":"1176-1188","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Links between gut microbiome, metabolome, clinical variables and non\u2010alcoholic fatty liver disease severity in bariatric patients"],"prefix":"10.1111","volume":"44","author":[{"given":"Katherine J. P.","family":"Schwenger","sequence":"first","affiliation":[{"name":"Toronto General Hospital University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Divya","family":"Sharma","sequence":"additional","affiliation":[{"name":"Toronto General Hospital University Health Network  Toronto Ontario Canada"},{"name":"Princess Margaret Cancer Centre University Health Network  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasaman","family":"Ghorbani","sequence":"additional","affiliation":[{"name":"Toronto General Hospital University Health Network  Toronto Ontario Canada"},{"name":"Institute of Medical Science University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Xu","sequence":"additional","affiliation":[{"name":"Princess Margaret Cancer Centre University Health Network  Toronto Ontario Canada"},{"name":"Dalla Lana School of Public Health University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy","family":"Lou","sequence":"additional","affiliation":[{"name":"Dalla Lana School of Public Health University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena M.","family":"Comelli","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra E.","family":"Fischer","sequence":"additional","affiliation":[{"name":"Toronto General Hospital University Health Network  Toronto Ontario Canada"},{"name":"Department of Laboratory Medicine and Pathobiology University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy D.","family":"Jackson","sequence":"additional","affiliation":[{"name":"Division of General Surgery 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