Short-chain fatty acids (SCFAs) are gut microbiota-derived products that participate in maintaining the gut barrier integrity and host's immune response. We hypothesize that reduced SCFA levels are associated with systemic
inflammation,
endotoxemia, and more severe hemodynamic alterations in
cirrhosis. Patients with
cirrhosis referred for a hepatic venous pressure gradient (HVPG) measurement (n = 62) or a transjugular intrahepatic
portosystemic shunt placement (n = 12) were included. SCFAs were measured in portal (when available), hepatic, and peripheral blood samples by GC-MS. Serum
endotoxins, proinflammatory
cytokines, and NO levels were quantified. SCFA levels were significantly higher in portal vs. hepatic and peripheral blood. There were inverse relationships between SCFAs and the severity of disease. SCFAs (mainly
butyric acid) inversely correlated with the model for
end-stage liver disease score and were further reduced in patients with history of
ascites,
hepatic encephalopathy, and spontaneous bacterial
peritonitis. There was an inverse relationship between
butyric acid and HVPG values. SCFAs were directly related with systemic vascular resistance and inversely with cardiac index.
Butyric acid inversely correlated with inflammatory markers and serum
endotoxin. A global reduction in the blood levels of SCFA in patients with
cirrhosis is associated with a more advanced
liver disease, suggesting its contribution to
disease progression.-Juanola, O., Ferrusquía-Acosta, J., García-Villalba, R., Zapater, P., Magaz, M., Marín, A., Olivas, P., Baiges, A., Bellot, P., Turon, F., Hernández-Gea, V., González-Navajas, J. M., Tomás-Barberán, F. A., García-Pagán, J. C., Francés, R. Circulating levels of
butyrate are inversely related to
portal hypertension,
endotoxemia, and systemic
inflammation in patients with
cirrhosis.