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已发表论文
粪菌移植联合生活方式干预治疗代谢功能障碍相关脂肪性肝病：两例病例报告及文献综述
Authors Liu N, Wang DX, Hao JX, Yan XF, Lv CL, Yan JG, Liu GF
Received 9 September 2025
Accepted for publication 29 October 2025
Published 19 November 2025 Volume 2025:18 Pages 4299—4307
DOI https://doi.org/10.2147/DMSO.S562310
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 4
Editor who approved publication: Professor Jae Woong Sull
Na Liu,1 Ding-Xin Wang,1 Jing-Xia Hao,2 Xiao-Feng Yan,3 Chun-Lan Lv,4 Jian-Guo Yan,5 Gai-Fang Liu1
1Department of Gastroenterology, Hebei General Hospital, Shijiazhuang, Hebei, 050051, People’s Republic of China; 2Department of Endocrinology, Hebei Children’s Hospital, Shijiazhuang, Hebei, 050031, People’s Republic of China; 3Chongqing Medical University, Chongqing, 401331, People’s Republic of China; 4Hebei Medical University, Shijiazhuang, Hebei, 050017, People’s Republic of China; 5Sifang College, Shijiazhuang Tiedao University, Shijiazhuang, Hebei, 051133, People’s Republic of China
Correspondence: Na Liu, Department of Gastroenterology, Hebei General Hospital, No. 348 of Heping West Road, Shijiazhuang, Hebei, 050051, People’s Republic of China, Tel +86 31185988856, Email liuna_lnhbgh@163.com
Abstract: Metabolic dysfunction-associated fatty liver disease (MAFLD) is highly prevalent condition, with gut microbiota dysbiosis playing a contributory role in its pathogenesis and progression. Fecal microbiota transplantation (FMT) has emerged as a potential therapeutic approach for MAFLD. This report describes two patients diagnosed with MAFLD who underwent FMT in combination with lifestyle intervention. Post treatment findings demonstrated notable improvements in body mass index (decreased by 20.7% and 3%, respectively), serum transaminases levels (decreased by 51% and 27.2%, respectively), lipid profiles, uric acid concentrations, and liver stiffness measurements (decreased by 22.2% and 24.2%, respectively). Additionally, microbiome analysis showed increased diversity, improved anti-inflammatory and colonization resistance capacity, reduced pathogens, and enriched probiotics. A review of seven Chinese and international randomized controlled trials (RCTs) investigating the application of FMT in MAFLD was conducted. Among these, four trials reported improvement in liver function post-treatment. Two trials reported reductions in small intestinal or gastric permeability, one trial demonstrated a decrease in homeostasis model assessment of insulin resistance (HOMA-IR), one trial noted a reduction in blood lipid levels, and one trial documented a decrease in fat attenuation index (FAI). Only one trial included histological evaluation of liver tissue before and after FMT, which did not demonstrate significant pathological improvement. The combination of FMT and lifestyle intervention has achieved quite satisfactory therapeutic effects in the treatment of MAFLD, providing new ideas and potential therapeutic targets for the management of MAFLD. This approach holds broad application prospects. However, further confirmation through large-scale RCTs is still needed.
Keywords: fecal microbiota transplantation, hepatic steatosis, lifestyle intervention, metabolic dysfunction-associated fatty liver disease, case report
1Department of Gastroenterology, Hebei General Hospital, Shijiazhuang, Hebei, 050051, People’s Republic of China; 2Department of Endocrinology, Hebei Children’s Hospital, Shijiazhuang, Hebei, 050031, People’s Republic of China; 3Chongqing Medical University, Chongqing, 401331, People’s Republic of China; 4Hebei Medical University, Shijiazhuang, Hebei, 050017, People’s Republic of China; 5Sifang College, Shijiazhuang Tiedao University, Shijiazhuang, Hebei, 051133, People’s Republic of China
Correspondence: Na Liu, Department of Gastroenterology, Hebei General Hospital, No. 348 of Heping West Road, Shijiazhuang, Hebei, 050051, People’s Republic of China, Tel +86 31185988856, Email liuna_lnhbgh@163.com
Abstract: Metabolic dysfunction-associated fatty liver disease (MAFLD) is highly prevalent condition, with gut microbiota dysbiosis playing a contributory role in its pathogenesis and progression. Fecal microbiota transplantation (FMT) has emerged as a potential therapeutic approach for MAFLD. This report describes two patients diagnosed with MAFLD who underwent FMT in combination with lifestyle intervention. Post treatment findings demonstrated notable improvements in body mass index (decreased by 20.7% and 3%, respectively), serum transaminases levels (decreased by 51% and 27.2%, respectively), lipid profiles, uric acid concentrations, and liver stiffness measurements (decreased by 22.2% and 24.2%, respectively). Additionally, microbiome analysis showed increased diversity, improved anti-inflammatory and colonization resistance capacity, reduced pathogens, and enriched probiotics. A review of seven Chinese and international randomized controlled trials (RCTs) investigating the application of FMT in MAFLD was conducted. Among these, four trials reported improvement in liver function post-treatment. Two trials reported reductions in small intestinal or gastric permeability, one trial demonstrated a decrease in homeostasis model assessment of insulin resistance (HOMA-IR), one trial noted a reduction in blood lipid levels, and one trial documented a decrease in fat attenuation index (FAI). Only one trial included histological evaluation of liver tissue before and after FMT, which did not demonstrate significant pathological improvement. The combination of FMT and lifestyle intervention has achieved quite satisfactory therapeutic effects in the treatment of MAFLD, providing new ideas and potential therapeutic targets for the management of MAFLD. This approach holds broad application prospects. However, further confirmation through large-scale RCTs is still needed.
Keywords: fecal microbiota transplantation, hepatic steatosis, lifestyle intervention, metabolic dysfunction-associated fatty liver disease, case report