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References

  1. Samuel VT, Shulman GI. 2018. Nonalcoholic fatty liver disease as a nexus of metabolic and hepatic diseases. Cell Metab. 27: 22-41.
    Pubmed PMC CrossRef
  2. Hyun J, Lee Y, Wang S, Kim J, Kim J, Cha JH, et al. 2016. Kombucha tea prevents obese mice from developing hepatic steatosis and liver damage. Food Sci. Biotechnol. 25: 861-866.
    Pubmed PMC CrossRef
  3. Michelotti GA, Machado MV, Diehl AM. 2018. NAFLD, NASH and liver cancer. Nat. Rev. Gastroenterol. Hepatol. 10: 656-665.
    Pubmed CrossRef
  4. Durazno M, Belci P, Collo A, Grisoglio E, Bo S. 2012. Focus on therapeutic strategies of nonalcoholic fatty liver disease. Int. J. Hepatol. 2012: 464706.
    Pubmed PMC CrossRef
  5. Carling D, Thornton C, Woods A, Sanders MJ. 2012. AMP-activated protein kinase: new regulation, new roles? Biochem. J. 445: 11-27.
    Pubmed CrossRef
  6. Viollet B, Guigas B, Leclerc J, Hébradrd S, Lantier L, Mounier R, et al. 2009. AMP-activated protein kinase in the regulation of hepatic energy metabolism: from physiology to therapeutic perspectives. Acta Physiol. 196: 81-98.
    Pubmed PMC CrossRef
  7. Moslehi A, Hamidi-zad Z. 2018. Role of SREBPs in liver diseases: a mini-review. J. Clin. Transl. Hepatol. 6: 332-338.
    Pubmed PMC CrossRef
  8. Smith BK, Marcinko K, Desjardins EM, Lally JS, Ford RJ, Steinberg GR. 2016. Treatment of nonalcoholic fatty liver disease: role of AMPK. Am. J. Physiol. Endocrinol. Metab. 311: E730-E740.
    Pubmed CrossRef
  9. Assifi MM, Suchankova G, Constant S, Prentki M, Saha AK, Ruderman NB. 2005. AMP-activated protein kinase and coordination of hepatic fatty acid metabolism of starved/carbohydrate-refed rats. Am. J. Physiol. Endocrinol. Metab. 289: E794-E800.
    Pubmed CrossRef
  10. Foretz M, Even PC, Viollet B. 2018. AMPK activation reduces hepatic lipid content by increasing fat oxidation in vivo. Int. J. Mol. Sci. 19: 2826.
    Pubmed PMC CrossRef
  11. Choi DJ, Kim SC, Park GE, Choi BR, Lee DY, Lee YV, et al. 2020. Protective effect of a mixture of Astragalus membranaceus and Lithospermum erythrothizon extract against hepatic steatosis in high fat diet-induced nonalcoholic fatty liver disease mice. Evid. Based Complement. Altern. Med. 2020: 8370698.
    Pubmed PMC CrossRef
  12. Lee NK, Park YS, Kang DK, Paik HD. 2023. Paraprobiotics: definition, manufacturing methods, and functionality. Food Sci. Biotechnol. 32: 1981-1991.
    Pubmed CrossRef
  13. Hyun JH, Yu HS, Woo IK, Lee GW, Lee NK, Paik HD. 2023. Anti-inflammatory activities of Levilactobacillus brevis KU15147 in RAW 264.7 cells stimulated with lipopolysaccharide on attenuating NF-κB, AP-1, and MAPK signaling pathways. Food Sci. Biotechnol. 32: 2105-1991.
    Pubmed CrossRef
  14. Kim WJ, Hyun JH, Lee NK, Paik HD. 2022. Protective effect of a novel Lactobacillus brevis strain with probiotic characteristics against Staphylococcus aureus lipoteichoic acid-induced intestinal inflammatory response. J. Microbiol. Biotechnol. 32: 205-211.
    Pubmed PMC CrossRef
  15. Huang Y, Wang X, Zhang L, Zheng K, Xiong J, Li J, et al. 2022. Effect of probiotics therapy on nonalcoholic fatty liver disease. Comput. Math Methods Med. 2022: 7888076.
    Pubmed PMC CrossRef
  16. Velayudham A, Dolganiuc A, Ellis M, Petrasek J, Kodys K, Mandrekar P, et al. 2009. VSL#3 probiotic treatment attenuates fibrosis without changes in steatohepatitis in a diet-induced nonalcoholic steatohepatitis model in mice. Hepatology 49: 989-997.
    Pubmed PMC CrossRef
  17. Cao F, Ding Q, Zhung H, Lai S, Chang K, Le C, et al. 2022. Lactobacillus plantarum ZJUIDS14 alleviates non-alcoholic fatty liver disease in mice in association with modulation in the gut microbiota. Front. Nutr. 9: 1071284.
    Pubmed PMC CrossRef
  18. Sun M, Wu T, Zhang G, Liu R, Sui W, Zhang M, et al. 2020. Lactobacillus rhamnosus LRa05 improves lipid accumulation in mice fed with a high fat diet via regulating the intestinal microbiota, reducing glucose content and promoting liver carbohydrate metabolism. Food Funct. 11: 9514-9525.
    Pubmed CrossRef
  19. Wu T, Zhang Y, Li W, Zhao Y, Long H, Muhindo EM, et al. 2021. Lactobacillus rhamnosus LRa05 ameliorate hyperglycemia through a regulating glucagon-mediated signaling pathway and gut microbiota in type 2 diabetic mice. J. Agric. Food Chem. 69: 8797-8806.
    Pubmed CrossRef
  20. Ryu BH, Lee KH, Kim YW, Lee DG, Yoon SC. 2007. Novel Lactobacillus plantarum from kimchi with inhibiting activities on pathogenic microorganism and use thereof. Patent. KR101485182B1.
  21. Chang BY, Bae JH, Lim CY, Kim YH, Kim TY, Kim SY. 2023. Tricin-enriched Zizania latifolia ameliorates non-alcoholic fatty liver disease through AMPK-dependent pathways. Food Sci. Biotechnol. 32: 2117-2129.
    Pubmed PMC CrossRef
  22. Mashek DG. 2020. Hepatic lipid droplets: a balancing act between energy storage and metabolic dysfunction in NAFLD. Mol. Metab. 50: 101115.
    Pubmed PMC CrossRef
  23. Meroni M, Longo M, Dongiovanni P. 2019. The role of probiotics nonalcoholic fatty liver disease: a new insight into therapeutic strategies. Nutrients 11: 2642.
    Pubmed PMC CrossRef
  24. Park SY, Choi JW, On DN, Kim DP, Yoon SY, Jang WJ, et al. 2023. Anti-obesity potential through regulation of carbohydrate uptake and gene expression in intestinal epithelial cells by the probiotics Lactiplantibacillus plantarum MGEL20154 from fermented food. J. Microbiol. Biotechnol. 33: 621-633.
    Pubmed PMC CrossRef
  25. Polyzos SA, Kountouras J, Mantzoros CS. 2019. Obesity and nonalcoholic fatty liver disease: from pathophysiology to therapeutics. Metabolism 92: 82-97.
    Pubmed CrossRef
  26. Kim JW, Lee YS, Seol DJ, Cho IJ, Ku SK, Choi JS, et al. 2018. Anti-obesity and fatty liver-preventing activities of Lonicera caerulea in high-fat diet-fed mice. Int. J. Mol. Med. 42: 3047-3064.
    CrossRef
  27. Hadizadeh F, Faghihimani E, Adivi P. 2017. Nonalcoholic fatty liver disease: diagnostic biomarkers. World Gastrointest. Pathophysiol. 15: 11-26.
    Pubmed PMC CrossRef
  28. Draijer L, Benninga M, Koot B. 2019. Pediatric NAFLD: an overview and recent developments in diagnostics and treatment. Expert Rev. Gastrolenterol. Hepatol. 13: 447-461.
    Pubmed CrossRef
  29. Fang C, Pan J, Qu N, Lei Y, Han J, Zhang J, Han D. 2022. The AMPK pathway in fatty liver disease. Front. Physiol. 13: 970292.
    Pubmed PMC CrossRef
  30. Moslehi A, Hamidi-zad Z. 2018. Role of SREBPs in liver diseases: a mini-review. J. Clin. Transl. Hepatol. 6: 332-338.
    Pubmed PMC CrossRef
  31. Kim HI, Kim JK, Kim JY, Jang SE, Han MJ, Kim DH. 2019. Lactobacillus plantarum LC27 and Bifidobacterium longum LC67 simultaneously alleviated HFD-induced colitis, endotoxemia, liver steatosis, and obesity in mice. Nutr. Res. 67: 78-89.
    Pubmed CrossRef
  32. Lee E, Jung SR, Lee SY, Lee NK, Paik HD, Lin SI. 2018. Lactobacillus plantarum strain Ln4 attenuates diet-induced obesity, insulin resistance, and changes in hepatic mRNA levels associated with glucose and lipid metabolism. Nutrients 10: 643.
    Pubmed PMC CrossRef
  33. Bauche IB, El Mkadem SA, Pottier AM, Senou M, Many MC, Rezsohazy R, et al. 2007. Overexpression of adiponectin targeted to adipose tissue in transgenic mice: Impaired adipocyte differentiation. Endocrinology 148: 1539-1549.
    Pubmed CrossRef
  34. Fabbrini E, Magkos F. 2015. Hepatic steatosis as a marker of metabolic dysfunction. Nutrients 7: 4995-5019.
    Pubmed PMC CrossRef

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Article

Research article

J. Microbiol. Biotechnol. 2024; 34(2): 399-406

Published online February 28, 2024 https://doi.org/10.4014/jmb.2310.10026

Copyright © The Korean Society for Microbiology and Biotechnology.

Hepatoprotective Effect of Lactiplantibacillus plantarum DSR330 in Mice with High Fat Diet-Induced Nonalcoholic Fatty Liver Disease

Na-Kyoung Lee1†, Yunjung Lee2†, Da-Soul Shin2, Jehyeon Ra3, Yong-Min Choi3, Byung Hee Ryu4, Jinhyeuk Lee3, Eunju Park2*, and Hyun-Dong Paik1*

1Department of Food Science and Biotechnology of Animal Resources, Konkuk University, Seoul 05029, Republic of Korea
2Department of Food and Nutrition, Kyungnam University, Changwon 51767, Republic of Korea
3FM MI center, Daesang Wellife, Seoul 03130, Republic of Korea
4Jongga R&D product Division, Daesang, Seoul 03130, Republic of Korea

Correspondence to:Eunju Park,             pej@kyungnam.ac.kr
Hyun-Dong Paik,     hdpaik@konkuk.ac.kr

Na-Kyoung Lee and Yunjung Lee contributed equally to this work.

Received: October 19, 2023; Revised: November 20, 2023; Accepted: November 22, 2023

Abstract

Lactiplantibacillus plantarum DSR330 (DSR330) has been examined for its antimicrobials production and probiotics. In this study, the hepatoprotective effects of DSR330 were examined against non-alcoholic fatty liver disease (NAFLD) in a high-fat diet (HFD)-fed C57BL/6 mouse model. To induce the development of fatty liver, a HFD was administered for five weeks, and then silymarin (positive control) or DSR330 (108 or 109 CFU/day) was administered along with the HFD for seven weeks. DSR330 significantly decreased body weight and altered serum and hepatic lipid profiles, including a reduction in triglyceride, total cholesterol, and low-density lipoprotein cholesterol levels compared to those in the HFD group. DSR330 significantly alleviated HFD-related hepatic injury by inducing morphological changes and reducing the levels of biomarkers, including AST, ALT, and ALP. Additionally, DSR330 alleviated the expression of SREBP-1c, ACC1, FAS, ACO, PPARα, and CPT-1 in liver cells. Insulin and leptin levels were decreased by DSR330 compared to those observed in the HFD group. However, adiponectin levels were increased, similar to those observed in the ND group. These results demonstrate that L. plantarum DSR330 inhibited HFD-induced hepatic steatosis in mice with NAFLD by modulating various signaling pathways. Hence, the use of probiotics can lead to hepatoprotective effects.

Keywords: Nonalcoholic fatty liver, hepatoprotective effect, probiotics, Lactiplantibacillus plantarum, animal model

Introduction

The liver plays a major role in whole-body lipogenesis, cholesterol metabolism, and gluconeogenesis [1]. However, non-alcoholic fatty liver disease (NAFLD) is associated with increased accumulation of hepatocellular lipids [2]. NAFLD leads to abnormal liver function and can progress to more severe liver diseases such as nonalcoholic steatohepatitis (NASH), fibrosis, and cirrhosis [3]. The process of NAFLD involves two key stages: 1) Excessive accumulation of triglycerides (TG) within hepatocytes; 2) An increase in pro-inflammatory adipokines and cytokines, including tumor necrosis factor (TNF)-α and interleukin (IL)-6, accompanied by mitochondrial dysfunction and oxidative stress [4].

The AMP-activated protein kinase (AMPK) signaling pathway plays a crucial role in maintaining cellular energy metabolism [5]. AMPK, which facilitates lipogenesis and fatty acid oxidation in the liver, has become a major target for NAFLD therapy or prevention of NAFLD [6]. AMPK activation mediates energy metabolism by suppressing acetyl-CoA carboxylase (ACC) and fatty acid synthase (FAS) expression via decreased transcriptional activation of sterol regulatory element-binding protein (SREBP)-1c [7, 8]. Activation of ACC upon stimulation of AMPK results in reduced malonyl-CoA synthesis, which reduces fatty acid synthesis and increases mitochondrial fatty acid oxidation via the regulation of carnitine palmitoyltransferase (CPT)-1 [9, 10].

Efforts to develop hepatoprotective or therapeutic agents for liver diseases have predominantly focused on exploring medicinal herbs or combinations of herbs [11]. Recently, probiotics have been reported to exert a protective effect on the gut–liver axis [12]. Probiotics have been used as nutritious ingredients for the treatment of diseases, such as colon inflammation and neuronal disorders [13, 14]. Probiotics influence the gut microbiota and their metabolites, such as short-chain fatty acids (SCFAs). Some probiotics influence liver enzymes, lipid metabolism, blood glucose-related indices, body mass, and inflammation in patients [15]. VSL#3, which consists of eight probiotic strains [16] comprising Lactiplantibacillus plantarum ZJUIDS14 [17], and Lactobacillus sp. [18, 19] can effectively decrease TG and total cholesterol (TC) levels in the serum and the potency of the inflammatory response. Hence, it can be used as an adjuvant treatment of NAFLD.

L. plantarum DSR330, isolated from Korean fermented foods, has probiotic properties, including resistance to gastric conditions and antimicrobial effects [20]. The objective of this study was to investigate the preventive effects against NAFLD of L. plantarum DSR330 in high-fat diet (HFD)-fed mice and to obtain functional insights into the role of lactic acid bacteria (LAB) in preventing NAFLD.

Materials and Methods

Preparations of Bacterial Samples

L. plantarum DSR330 (DSR330, KFCC 11393P) was isolated from kimchi in Korea [20]. DSR330 was cultured as a probiotic in general media. The cultured strain was centrifuged and resuspended in PBS (HyClone, USA) or 1% glucose. The harvested strain was lyophilized and used for the development of animal models.

Animal Groups and Experimental Design

Four-week-old, male C57BL/6 mice were purchased from Koatech (Republic of Korea). Mice were housed 3–4 per cage at 23 ± 2°C and 53 ± 2% relative humidity with a 12-h light/dark cycle. After one week of acclimatization, mice were randomly assigned to five groups (n=8) as follows: (1) normal-food diet (ND, 10% kcal fat), (2) HFD, high fat diet (60% kcal fat), (3) HFD with silymarin (Silymarin), (4) HFD with 108 CFU/day of DSR330 (DSR-8), and (5) HFD with 109 CFU/day of DSR330 (DSR-9). To induce the development of fatty liver, the HFD was administered for five weeks, and then silymarin (200 mg/kg) or DSR330 (108 or 109 CFU/day) was administered along with the HFD for an additional seven weeks. The body weight and food intake were measured weekly. At the end of the experimental period, all mice were subjected to fasting for 12 h, and their livers were collected for further analysis. All experimental protocols were performed in accordance with the guidelines of the Institutional Animal Care of Kyungnam University (KUICA-22-09).

After 12 weeks, the experimental animals were subjected to fasting for 12 h and anesthetized with isoflurane (4 ml/kg). Blood was collected and centrifuged at 2,000 ×g for 30 min to separate the serum. After blood collection, the organs were harvested and evaluated. All samples were stored at –80°C until further analysis.

Histological Analysis of Liver Samples

The liver tissues were fixed in 10% paraformaldehyde for 24 h. Subsamples of hepatic tissues were embedded in paraffin. The tissues were cut into 4-μm-thick sections, stained with hematoxylin and eosin (H&E), and evaluated by light microscopy.

Biochemical Analysis of Serum and Liver Samples

Serum levels of triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), alanine transaminase (ALT), alkaline phosphatase (ALP), and aspartate transaminase (AST) were determined using a determination kit (BioSystems, Spain) according to the manufacturer’s guidelines.

RNA Extraction and Quantitative Real-Time Polymerase Chain Reaction (PCR)

Total RNA was extracted from the liver and subcutaneous adipose tissue using the TRIzol Reagent (Invitrogen, USA). The cDNAs were synthesized from 1 μg of RNA using M-MLV reverse transcriptase (Promega, USA). After cDNA synthesis, quantitative real-time PCR was performed using 25 μl of SYBR Green master mix (PhileKorea, QuantiSpeed SYBR No-ROX kit, Korea) with Real-time DNA thermal cycler (CFX Duet real-time PCR system, Bio-Rad, USA). The reaction mixtures were incubated for initial denaturation at 95°C for 10 min, followed by 50 cycles of PCR. Each cycle was performed as per the following parameters: 95°C for 10 s, 55°C for 20 s, and 72°C for 20 s. The sequences of the sense and antisense primers used for amplification are listed as follows: PPARγ, sense, 5'-ccacactatgaagacattccat-3' and antisense, 5'-gttctactttgatcgcactttg-3'; SREBP-1c, sense, 5'-gtgtgcaccgtagttctggg-3' and antisense, 5'-aggtcagcttgtttgcgatg-3'; ACC1, sense, 5'-ccctacacttactgatgagc-3' and antisense, 5'-gggaagcaataagaacctga- 3'; FAS, sense, 5'-aagaaagtgctggaaaagga-3' and antisense, 5'-cagcaattctcgggatgtat-3'; ACO, sense, 5'-attaagtcgccaccattctt-3' and antisense, 5'-ggtccgttgttactgaatct-3'; PPARα, sense, 5'-gaatccacgaagcctacc-3' and antisense, 5'-gccatacacaaggtatcc- 3'; CPT-1, sense, 5'-aagatcaatcggaccctaga-3' and antisense, 5'-atagtcatgatgatcgaaac-3'. The β-Actin-encoding gene was used as a reference gene. The normalized target gene expression levels in the sample were calculated using 2ΔΔCT. Values were expressed as fold change compared to control and are represented as the mean ± SE (n = 7).

Analysis of Hormones Related to Energy Metabolism

Serum insulin, adiponectin, and leptin levels were measured using a microplate reader (Epoch, BioTek Instruments Inc., USA) with an ELISA kit (BioVendor R&D, Czech).

Statistical Analysis

All data are presented as the mean ± standard error. One-way analysis of variance and Duncan’s multiple range test were used to compare multiple groups. The results were considered statistically significant at p < 0.05, and all statistical analyses were conducted using the SPSS software (IBM, USA).

Results

Reduction in Body Fat and Liver Weight in Mice with NAFLD Mediated by DSR330

The HFD was administered for five weeks to induce the development of fatty liver in the NAFLD mouse model. After five weeks, silymarin and DSR were administered to treat NAFLD for 12 weeks. Body weight and body fat are presented in Fig. 1A and Table 1. The body weights of the mice in each group showed an increasing trend. The body weight of the HFD group (39.58 ± 1.98 g) increased significantly compared with the ND group (29.43 ± 1.31 g). The body weight was significantly reduced after administration of silymarin (32.50 ± 1.30 g), DSR-8 (36.93 ± 1.53 g), and DSR-9 (33.86 ± 1.09 g) treatment for 12 weeks. Liver weight in silymarin- and DSR-8-treated groups was reduced by 79.10% (2.46 ± 0.38 g/100 g BW) and 84.57% (2.63 ± 0.11 g/100 g BW), respectively, compared to the HFD (3.09 ± 0.64 g/100 g BW) group (data not shown). The HFD increased hepatic steatosis, as determined by hematoxylin and eosin staining (Fig. 1B). The fatty livers showed degermation and the formation of lipid droplets in the HFD group, whereas the livers showed decreased variations in the DSR groups (Fig. 1B). The body fat was characterized as brown, subcutaneous, and visceral (Table 1). HFD increased subcutaneous fat and visceral fat compared to ND. The administration of silymarin and DSR-9 led to notable variations in subcutaneous fat within this dataset.

Table 1 . Effects of Lactiplantibacillus plantarum DSR330 on the body fat of HFD-fed mice..

VariableNDHFDSilymarinDSR-8DSR-9
Relative adipose tissue weight (g/100 g BW)
Brown fat0.40 ± 0.05b0.30 ± 0.03ab0.27 ± 0.05ab0.37 ± 0.04ab0.28 ± 0.04ab
Subcutaneous fat1.02 ± 0.16a2.62 ± 0.49c1.29 ± 0.28ab2.42 ± 0.31bc2.04 ± 0.27ab
Visceral fat4.09 ± 0.31a7.66 ± 0.73b6.41 ± 1.03b8.53 ± 0.81b6.82 ± 0.76b
Epididymal fat2.31 ± 0.17a4.28 ± 0.37b4.18 ± 0.58b5.17 ± 0.46b4.26 ± 0.45b
Retroperitioneal and perirenal0.57 ± 0.11a1.93 ± 0.29ab1.14 ± 0.36ab1.61 ± 0.29ab1.37 ± 0.29ab
Mesenteric fat1.22 ± 0.23ns1.45 ± 0.351.10 ± 0.341.74 ± 0.561.19 ± 0.31

ND, normal diet (10% kcal fat); HFD, high-fat diet (60% kcal fat); Silymarin, HFD with silymarin; DSR-8, HFD with 108 CFU/day of DSR330; DSR-9, HFD with 109 CFU/day of DSR330..

Values represent mean ± standard error..

Values with different letters indicate significant differences calculated at p < 0.05 according to Duncan's multiple-range test..

nsnot significant..



Figure 1. Effects of Lactiplantibacillus plantarum DSR330 on HFD-fed mice (n = 8). (A) Body weight, (B) H&Estained liver tissue. Data are presented as mean ± standard error of triplicate experiments. Different letters on the error bars represent significant differences (p < 0.05). ND, normal-food-diet (10% kcal fat); HFD, high-fat-diet (60% kcal fat); Silymarin, HFD with silymarin; DSR-8, HFD with 108 CFU/day of DSR330; DSR-9, HFD with 109 CFU/day of DSR330.

Alleviatory Effects of DSR330 on Hepatic Steatosis and Liver Damage in Mice with NAFLD

Assessment of liver function-related enzymes and an increase in AST, ALT, and ALP in serum can help detect damage to hepatocytes and the biliary tract [21, 22]. The results of Fig. 2 represent the liver damage based on levels of biomarkers in the serum. The values of AST (3.69-fold), ALT (2.46-fold), and ALP (1.43-fold) in the HFD group increased compared to those in the ND group (Fig. 2A-C). DSR decreased AST (0.76~0.78-fold), ALT (0.62~0.71-fold), and ALP (0.77~0.80-fold) levels compared to those observed in the HFD group. DSR was more effective than silymarin with respect to reduction in ALP levels.

Figure 2. Effects of Lactiplantibacillus plantarum DSR330 on hepatic steatosis in the liver of HFD-fed mice (n = 8). (A) AST, (B) ALT, and (C) ALP levels. Data are presented as mean ± standard error of triplicate experiments. Different letters on the error bars represent significant differences (p < 0.05). ND, normal-food-diet (10% kcal fat); HFD, high-fat-diet (60% kcal fat); Silymarin, HFD with silymarin; DSR-8, HFD with 108 CFU/day of DSR330; DSR-9, HFD with 109 CFU/day of DSR330.

Effects of DSR330 on Serum Lipids in Mice with NAFLD

Fig. 3 shows the serum lipid variables in mice with NAFLD. Serum TG, TC, and LDL levels in the HFD group increased by 130.2% (51.69 ± 3.07 mg/dl), 162.83% (104.93 ± 6.46 mg/dl), and 353.04% (80.67 ± 5.75 mg/dl) compared to those of the ND group, respectively. DSR-9 significantly reduced these levels by 74.23%(38.37 ± 2.35 mg/dl), 62.55% (65.63 ± 3.77 mg/dl), and 26.59% (21.45 ± 4.41 mg/dl), respectively. The DSR-9 group exhibited similarity to the ND group concerning all the measured variables. In addition, the level of HDL-cholesterol increased by 182.11% (44.18 ± 1.29 mg/dl) compared to that in the HFD (24.26 ± 1.45 mg/dl) group, and these values were similar to those observed in the ND group. In particular, DSR was more effective than silymarin in reducing the levels of serum lipids.

Figure 3. Effects of Lactiplantibacillus plantarum DSR330 on serum lipid profiles of HFD-fed mice (n = 8). (A) Triglyceride, (B) total cholesterol, (C) HDL-cholesterol, and (D) LDL-cholesterol levels. The data are presented as mean ± standard error of triplicate experiments. Different letters on the error bars represent significant differences (p < 0.05). ND, normal-food-diet (10% kcal fat); HFD, high-fat-diet (60% kcal fat); Silymarin, HFD with silymarin; DSR-8, HFD with 108 CFU/ day of DSR330; DSR-9, HFD with 109 CFU/day of DSR330.

Effects of DSR330 on Lipid Synthesis, Lipolysis, and Fatty Oxidation in the Liver of Mice with NAFLD

The mRNA expression of PPARγ and SREBP-1c, two key transcription factors regulating lipid synthesis, was increased in the HFD group (Table 2). However, DSR treatment decreased SREBP-1c expression. In addition, DSR reduced the levels of ACC1 and FAS, which are downstream targets of PPARγ and SREBP-1c. ACO, PPARα, and CPT-1 are related to fatty acid oxidation and adiponectin production (Table 3). While the HFD led to a decrease in these factors, both the DSR and the ND groups showed an increase, similar to the silymarin group.

Table 2 . Effect of Lactiplantibacillus plantarum DSR330 on relative gene expression associated with adipocyte differentiation and fat synthesis in HFD-fed mice..

VariableNDHFDSilymarinDSR-8DSR-9
PPARγ1.07 ± 0.06bc1.55 ± 0.33c0.31 ± 0.05a1.42 ± 0.19c0.80 ± 0.08ab
SREBP-1c1.70 ± 0.14a12.29 ± 0.48c4.49 ± 0.75b12.35 ± 0.90c4.39 ± 0.49b
ACC11.15 ± 0.08c0.18 ± 0.06a0.59 ± 0.17b0.93 ± 0.13bc0.66 ± 0.09b
FAS1.09 ± 0.01ab4.86 ± 0.37d0.94 ± 0.33ab1.56 ± 0.20c0.66 ± 0.01a

ND, normal diet (10% kcal fat); HFD, high-fat diet (60% kcal fat); Silymarin, HFD with silymarin; DSR-8, HFD with 108 CFU/day of DSR330; DSR-9, HFD with 109 CFU/day of DSR330..

Values represent the mean ± standard error..

Values with different letters indicate significant differences calculated at p < 0.05 according to Duncan's multiple-range test..



Table 3 . Effect of Lactiplantibacillus plantarum DSR330 on relative gene expression associated with lipolysis and fatty oxidation in liver tissue..

VariableNDHFDSilymarinDSR-8DSR-9
ACO1.05 ± 0.03b0.48 ± 0.10a0.87 ± 0.12b1.60 ± 0.13c0.90 ± 0.13b
PPARα1.18 ± 0.02d0.52 ± 0.02a0.70 ± 0.03b0.96 ± 0.05c0.69 ± 0.06b
CPT-11.09 ± 0.05c0.25 ± 0.02a0.50 ± 0.11b0.91 ± 0.08c0.68 ± 0.07b

ND, normal diet (10% kcal fat); HFD, high-fat diet (60% kcal fat); Silymarin, HFD with silymarin; DSR-8, HFD with 108 CFU/day of DSR330; DSR-9, HFD with 109 CFU/day of DSR330..

Values represent the mean ± standard error..

Values with different letters indicate significant differences calculated at p < 0.05 according to Duncan's multiple-range test..



Effect of DSR330 on Insulin, Adiponectin, and Leptin Levels in Mice with NAFLD

The data collected after the evaluation of metabolic hormones are presented in Table 4. The insulin and leptin levels were higher in the HFD group than in the ND group. However, silymarin, DSR-8, and DSR-9 treatments decreased the secretion of these hormones. Adiponectin levels decreased in the case of increased HFD treatment. Silymarin, DSR-8, and DSR-9 treatments exhibited similarity to the ND group, indicating a prophylactic effect on fatty liver in NAFLD mice.

Table 4 . Effect of Lactiplantibacillus plantarum DSR330 on hormone related to serum energy metabolism..

VariableNDHFDSilymarinDSR-8DSR-9
Insulin (ng/ml)1.65 ± 0.35a11.61 ± 0.19c2.45 ± 0.25b2.73 ± 0.13b2.51 ± 0.34b
Adiponectin (μg/ml)28.72 ± 1.87b13.62 ± 1.85a25.23 ± 2.74b29.19 ± 0.79b29.95 ± 0.79b
Leptin (ng/ml)13.98 ± 0.54a75.61 ± 0.94e24.66 ± 1.42b43.29 ± 1.21c46.83 ± 1.46d

ND, normal diet (10% kcal fat); HFD, high-fat diet (60% kcal fat); Silymarin, HFD with silymarin; DSR-8, HFD with 108 CFU/day of DSR330; DSR-9, HFD with 109 CFU/day of DSR330..

Values are the mean ± standard error..

Values with different letters are significantly different at p < 0.05, according to Duncan's multiple-range test..


Discussion

This study demonstrated that the administration of DSR330 significantly alleviated metabolic disorders in HFD-fed mice. NAFLD is characterized by the accumulation of fat droplets in hepatocytes [4] and an increase in liver weight and TG levels. DSR330 reduced liver weight and TG levels, suggesting that DSR330 was well able to alleviate steatosis. H&E staining of liver tissues revealed liver steatosis and vacuolar degeneration in the HFD group, suggesting that HFD induced histopathological damage. However, treatment with DSR330 alleviated liver dysfunction and damage, which was further confirmed by changes in the AST, ALT, and ALP levels.

Obesity can lead to dysbiosis of the gut microbiota via disruption of the intestinal barrier, including tight junction proteins (claudins and ZO-1), the mucus layer (Muc2), and IgA secretion [23]. These conditions can be attributed to metabolic diseases, including type 2 diabetes mellitus, cardiovascular disease, NAFLD, and hypertension [24, 25]. L. plantarum MGEL20154 has shown anti-obesity and probiotic effects [24]. In addition, medicinal plants, such as blue honeysuckle, have shown anti-obesity and fatty liver preventive effects [25].

Serum AST, ALT, and ALP levels are major enzymes present in hepatocytes, and their levels increase following hepatocellular injury [26]. Among these biomarkers, ALT is particularly sensitive and closely associated with NAFLD [27]. In many clinical studies examining NAFLD, increased ALT levels have been considered independent predictors [28]. Probiotics can modify gut dysbiosis caused by obesity, leading to anti-inflammatory effects under inflammatory conditions [13].

Thus, obesity-induced liver damage can be alleviated, leading to a reduction in ALT and AST levels after the administration of probiotics [23]. DSR330 significantly decreased the HFD-induced elevation in serum AST, ALT, and ALP levels in the liver tissue of HFD-fed mice (Fig. 2). Moreover, histopathological observation of liver tissues by H&E staining showed that DSR330 markedly attenuated the excessive formation and accumulation of lipid droplets in hepatocytes.

DSR330 downregulated lipid metabolism related to lipogenesis and lipid oxidation in the liver of HFD-fed mice (Tables 2 and 3). In addition, DSR330 was able to predict the potential activation of the AMPK signaling pathway related to fatty acid oxidation in the liver. In obesity mouse model, upregulation of AMK can alleviate fatty liver disease [11, 29]. In addition, AMPK activity can inhibit fatty acid synthesis and cholesterol by lowering of FAS, SREBP-1c, and ACC as our data. These results demonstrate that DSR330 treatment negatively regulates the expression of lipogenesis-related proteins, including SREBP-1c and FAS, in the liver tissues of HFD-fed mice. SREBP-1c is an important transcription factor that regulates fatty acid, cholesterol, and TG synthesis, whereas FAS is involved in lipid accumulation [30]. Multi-strain probiotics, including Bifidobacterium longum LC67 and L. plantarum LC67, have been reported to alleviate liver steatosis in HFD-fed mice [31]. These strains regulate the activation of NF-κB and AMPK.

Some LABs have been reported to exert antiobesity effects via modulation of the metabolic pathways [32]. DSR330 mitigated changes in leptin, insulin, and adiponectin levels (Table 4). The NAFLD model showed increased leptin and insulin levels and decreased adiponectin levels. Leptin shows anti-steatosis effects in the early stages of NAFLD, which are mediated via fatty acid oxidation and a reduction in lipogenesis. Furthermore, it shows proinflammatory and pro-fibrotic effects at later disease stages by increasing hepatic reactive oxygen species generation and proinflammatory cytokine release and enhancing fibrinogenesis. Adiponectin regulates several metabolic functions, including glucose control and fatty acid oxidation. A reduction in adipocyte differentiation and an increase in energy expenditure associated with mitochondrial uncoupling is attributed to increased blood adiponectin concentrations [33, 34].

In summary, DSR330 showed hepatoprotective effects against NAFLD in HFD-fed mice. DSR330 significantly decreased body weight and liver weight and altered serum and hepatic lipid profiles, including a reduction in triglyceride, total cholesterol, and LDL cholesterol levels. DSR330 significantly reduced the levels of HFD-related hepatic injury markers, including AST, ALT, and ALP. Additionally, DSR330 downregulated the expression of SREBP-1c and FAS and upregulated the expression of ACC1. In addition, the levels of ACO, PPARα, and CPT-1 related to lipolysis and fatty oxidation were increased. Hormones related to energy metabolism were modulated by DSR330. These results demonstrate that L. plantarum DSR330 inhibited HFD-induced hepatic steatosis in mice with NAFLD by modulating signaling pathways and hormones, suggesting hepatoprotective effects of probiotics.

Acknowledgments

This study was supported by the Korea Institute of Planning and Evaluation for Technology in Food, Agriculture, and Forestry(IPET) through the Technology Commercialization Support Program funded by the Ministry of Agriculture, Food, and Rural Affairs (MAFRA) (122040-02-2-SB010).

Conflict of Interest

The authors have no financial conflicts of interest to declare.

Abbreviations

ACC1 Acetyl CoA carboxylase 1

ACO Acyl-CoA oxidase

ALP Alkaline phosphatase

ALT Alanine aminotransferase

AST Aspartate aminotransferase

CPT-1 Carnitine palmitoyltransferase 1

FAS Fatty acid synthase

HFD High-fat diet

HSL Hormone-sensitive lipase

NAFLD Non-alcoholic fatty liver disease

NASH Non-alcoholic steatohepatitis

PPARα Peroxisome proliferator-activated receptor alpha

PPARγ Peroxisome proliferator-activated receptor gamma

SREBP-1c Sterol regulatory element-binding protein-1c

Fig 1.

Figure 1.Effects of Lactiplantibacillus plantarum DSR330 on HFD-fed mice (n = 8). (A) Body weight, (B) H&Estained liver tissue. Data are presented as mean ± standard error of triplicate experiments. Different letters on the error bars represent significant differences (p < 0.05). ND, normal-food-diet (10% kcal fat); HFD, high-fat-diet (60% kcal fat); Silymarin, HFD with silymarin; DSR-8, HFD with 108 CFU/day of DSR330; DSR-9, HFD with 109 CFU/day of DSR330.
Journal of Microbiology and Biotechnology 2024; 34: 399-406https://doi.org/10.4014/jmb.2310.10026

Fig 2.

Figure 2.Effects of Lactiplantibacillus plantarum DSR330 on hepatic steatosis in the liver of HFD-fed mice (n = 8). (A) AST, (B) ALT, and (C) ALP levels. Data are presented as mean ± standard error of triplicate experiments. Different letters on the error bars represent significant differences (p < 0.05). ND, normal-food-diet (10% kcal fat); HFD, high-fat-diet (60% kcal fat); Silymarin, HFD with silymarin; DSR-8, HFD with 108 CFU/day of DSR330; DSR-9, HFD with 109 CFU/day of DSR330.
Journal of Microbiology and Biotechnology 2024; 34: 399-406https://doi.org/10.4014/jmb.2310.10026

Fig 3.

Figure 3.Effects of Lactiplantibacillus plantarum DSR330 on serum lipid profiles of HFD-fed mice (n = 8). (A) Triglyceride, (B) total cholesterol, (C) HDL-cholesterol, and (D) LDL-cholesterol levels. The data are presented as mean ± standard error of triplicate experiments. Different letters on the error bars represent significant differences (p < 0.05). ND, normal-food-diet (10% kcal fat); HFD, high-fat-diet (60% kcal fat); Silymarin, HFD with silymarin; DSR-8, HFD with 108 CFU/ day of DSR330; DSR-9, HFD with 109 CFU/day of DSR330.
Journal of Microbiology and Biotechnology 2024; 34: 399-406https://doi.org/10.4014/jmb.2310.10026

Table 1 . Effects of Lactiplantibacillus plantarum DSR330 on the body fat of HFD-fed mice..

VariableNDHFDSilymarinDSR-8DSR-9
Relative adipose tissue weight (g/100 g BW)
Brown fat0.40 ± 0.05b0.30 ± 0.03ab0.27 ± 0.05ab0.37 ± 0.04ab0.28 ± 0.04ab
Subcutaneous fat1.02 ± 0.16a2.62 ± 0.49c1.29 ± 0.28ab2.42 ± 0.31bc2.04 ± 0.27ab
Visceral fat4.09 ± 0.31a7.66 ± 0.73b6.41 ± 1.03b8.53 ± 0.81b6.82 ± 0.76b
Epididymal fat2.31 ± 0.17a4.28 ± 0.37b4.18 ± 0.58b5.17 ± 0.46b4.26 ± 0.45b
Retroperitioneal and perirenal0.57 ± 0.11a1.93 ± 0.29ab1.14 ± 0.36ab1.61 ± 0.29ab1.37 ± 0.29ab
Mesenteric fat1.22 ± 0.23ns1.45 ± 0.351.10 ± 0.341.74 ± 0.561.19 ± 0.31

ND, normal diet (10% kcal fat); HFD, high-fat diet (60% kcal fat); Silymarin, HFD with silymarin; DSR-8, HFD with 108 CFU/day of DSR330; DSR-9, HFD with 109 CFU/day of DSR330..

Values represent mean ± standard error..

Values with different letters indicate significant differences calculated at p < 0.05 according to Duncan's multiple-range test..

nsnot significant..


Table 2 . Effect of Lactiplantibacillus plantarum DSR330 on relative gene expression associated with adipocyte differentiation and fat synthesis in HFD-fed mice..

VariableNDHFDSilymarinDSR-8DSR-9
PPARγ1.07 ± 0.06bc1.55 ± 0.33c0.31 ± 0.05a1.42 ± 0.19c0.80 ± 0.08ab
SREBP-1c1.70 ± 0.14a12.29 ± 0.48c4.49 ± 0.75b12.35 ± 0.90c4.39 ± 0.49b
ACC11.15 ± 0.08c0.18 ± 0.06a0.59 ± 0.17b0.93 ± 0.13bc0.66 ± 0.09b
FAS1.09 ± 0.01ab4.86 ± 0.37d0.94 ± 0.33ab1.56 ± 0.20c0.66 ± 0.01a

ND, normal diet (10% kcal fat); HFD, high-fat diet (60% kcal fat); Silymarin, HFD with silymarin; DSR-8, HFD with 108 CFU/day of DSR330; DSR-9, HFD with 109 CFU/day of DSR330..

Values represent the mean ± standard error..

Values with different letters indicate significant differences calculated at p < 0.05 according to Duncan's multiple-range test..


Table 3 . Effect of Lactiplantibacillus plantarum DSR330 on relative gene expression associated with lipolysis and fatty oxidation in liver tissue..

VariableNDHFDSilymarinDSR-8DSR-9
ACO1.05 ± 0.03b0.48 ± 0.10a0.87 ± 0.12b1.60 ± 0.13c0.90 ± 0.13b
PPARα1.18 ± 0.02d0.52 ± 0.02a0.70 ± 0.03b0.96 ± 0.05c0.69 ± 0.06b
CPT-11.09 ± 0.05c0.25 ± 0.02a0.50 ± 0.11b0.91 ± 0.08c0.68 ± 0.07b

ND, normal diet (10% kcal fat); HFD, high-fat diet (60% kcal fat); Silymarin, HFD with silymarin; DSR-8, HFD with 108 CFU/day of DSR330; DSR-9, HFD with 109 CFU/day of DSR330..

Values represent the mean ± standard error..

Values with different letters indicate significant differences calculated at p < 0.05 according to Duncan's multiple-range test..


Table 4 . Effect of Lactiplantibacillus plantarum DSR330 on hormone related to serum energy metabolism..

VariableNDHFDSilymarinDSR-8DSR-9
Insulin (ng/ml)1.65 ± 0.35a11.61 ± 0.19c2.45 ± 0.25b2.73 ± 0.13b2.51 ± 0.34b
Adiponectin (μg/ml)28.72 ± 1.87b13.62 ± 1.85a25.23 ± 2.74b29.19 ± 0.79b29.95 ± 0.79b
Leptin (ng/ml)13.98 ± 0.54a75.61 ± 0.94e24.66 ± 1.42b43.29 ± 1.21c46.83 ± 1.46d

ND, normal diet (10% kcal fat); HFD, high-fat diet (60% kcal fat); Silymarin, HFD with silymarin; DSR-8, HFD with 108 CFU/day of DSR330; DSR-9, HFD with 109 CFU/day of DSR330..

Values are the mean ± standard error..

Values with different letters are significantly different at p < 0.05, according to Duncan's multiple-range test..


References

  1. Samuel VT, Shulman GI. 2018. Nonalcoholic fatty liver disease as a nexus of metabolic and hepatic diseases. Cell Metab. 27: 22-41.
    Pubmed KoreaMed CrossRef
  2. Hyun J, Lee Y, Wang S, Kim J, Kim J, Cha JH, et al. 2016. Kombucha tea prevents obese mice from developing hepatic steatosis and liver damage. Food Sci. Biotechnol. 25: 861-866.
    Pubmed KoreaMed CrossRef
  3. Michelotti GA, Machado MV, Diehl AM. 2018. NAFLD, NASH and liver cancer. Nat. Rev. Gastroenterol. Hepatol. 10: 656-665.
    Pubmed CrossRef
  4. Durazno M, Belci P, Collo A, Grisoglio E, Bo S. 2012. Focus on therapeutic strategies of nonalcoholic fatty liver disease. Int. J. Hepatol. 2012: 464706.
    Pubmed KoreaMed CrossRef
  5. Carling D, Thornton C, Woods A, Sanders MJ. 2012. AMP-activated protein kinase: new regulation, new roles? Biochem. J. 445: 11-27.
    Pubmed CrossRef
  6. Viollet B, Guigas B, Leclerc J, Hébradrd S, Lantier L, Mounier R, et al. 2009. AMP-activated protein kinase in the regulation of hepatic energy metabolism: from physiology to therapeutic perspectives. Acta Physiol. 196: 81-98.
    Pubmed KoreaMed CrossRef
  7. Moslehi A, Hamidi-zad Z. 2018. Role of SREBPs in liver diseases: a mini-review. J. Clin. Transl. Hepatol. 6: 332-338.
    Pubmed KoreaMed CrossRef
  8. Smith BK, Marcinko K, Desjardins EM, Lally JS, Ford RJ, Steinberg GR. 2016. Treatment of nonalcoholic fatty liver disease: role of AMPK. Am. J. Physiol. Endocrinol. Metab. 311: E730-E740.
    Pubmed CrossRef
  9. Assifi MM, Suchankova G, Constant S, Prentki M, Saha AK, Ruderman NB. 2005. AMP-activated protein kinase and coordination of hepatic fatty acid metabolism of starved/carbohydrate-refed rats. Am. J. Physiol. Endocrinol. Metab. 289: E794-E800.
    Pubmed CrossRef
  10. Foretz M, Even PC, Viollet B. 2018. AMPK activation reduces hepatic lipid content by increasing fat oxidation in vivo. Int. J. Mol. Sci. 19: 2826.
    Pubmed KoreaMed CrossRef
  11. Choi DJ, Kim SC, Park GE, Choi BR, Lee DY, Lee YV, et al. 2020. Protective effect of a mixture of Astragalus membranaceus and Lithospermum erythrothizon extract against hepatic steatosis in high fat diet-induced nonalcoholic fatty liver disease mice. Evid. Based Complement. Altern. Med. 2020: 8370698.
    Pubmed KoreaMed CrossRef
  12. Lee NK, Park YS, Kang DK, Paik HD. 2023. Paraprobiotics: definition, manufacturing methods, and functionality. Food Sci. Biotechnol. 32: 1981-1991.
    Pubmed CrossRef
  13. Hyun JH, Yu HS, Woo IK, Lee GW, Lee NK, Paik HD. 2023. Anti-inflammatory activities of Levilactobacillus brevis KU15147 in RAW 264.7 cells stimulated with lipopolysaccharide on attenuating NF-κB, AP-1, and MAPK signaling pathways. Food Sci. Biotechnol. 32: 2105-1991.
    Pubmed CrossRef
  14. Kim WJ, Hyun JH, Lee NK, Paik HD. 2022. Protective effect of a novel Lactobacillus brevis strain with probiotic characteristics against Staphylococcus aureus lipoteichoic acid-induced intestinal inflammatory response. J. Microbiol. Biotechnol. 32: 205-211.
    Pubmed KoreaMed CrossRef
  15. Huang Y, Wang X, Zhang L, Zheng K, Xiong J, Li J, et al. 2022. Effect of probiotics therapy on nonalcoholic fatty liver disease. Comput. Math Methods Med. 2022: 7888076.
    Pubmed KoreaMed CrossRef
  16. Velayudham A, Dolganiuc A, Ellis M, Petrasek J, Kodys K, Mandrekar P, et al. 2009. VSL#3 probiotic treatment attenuates fibrosis without changes in steatohepatitis in a diet-induced nonalcoholic steatohepatitis model in mice. Hepatology 49: 989-997.
    Pubmed KoreaMed CrossRef
  17. Cao F, Ding Q, Zhung H, Lai S, Chang K, Le C, et al. 2022. Lactobacillus plantarum ZJUIDS14 alleviates non-alcoholic fatty liver disease in mice in association with modulation in the gut microbiota. Front. Nutr. 9: 1071284.
    Pubmed KoreaMed CrossRef
  18. Sun M, Wu T, Zhang G, Liu R, Sui W, Zhang M, et al. 2020. Lactobacillus rhamnosus LRa05 improves lipid accumulation in mice fed with a high fat diet via regulating the intestinal microbiota, reducing glucose content and promoting liver carbohydrate metabolism. Food Funct. 11: 9514-9525.
    Pubmed CrossRef
  19. Wu T, Zhang Y, Li W, Zhao Y, Long H, Muhindo EM, et al. 2021. Lactobacillus rhamnosus LRa05 ameliorate hyperglycemia through a regulating glucagon-mediated signaling pathway and gut microbiota in type 2 diabetic mice. J. Agric. Food Chem. 69: 8797-8806.
    Pubmed CrossRef
  20. Ryu BH, Lee KH, Kim YW, Lee DG, Yoon SC. 2007. Novel Lactobacillus plantarum from kimchi with inhibiting activities on pathogenic microorganism and use thereof. Patent. KR101485182B1.
  21. Chang BY, Bae JH, Lim CY, Kim YH, Kim TY, Kim SY. 2023. Tricin-enriched Zizania latifolia ameliorates non-alcoholic fatty liver disease through AMPK-dependent pathways. Food Sci. Biotechnol. 32: 2117-2129.
    Pubmed KoreaMed CrossRef
  22. Mashek DG. 2020. Hepatic lipid droplets: a balancing act between energy storage and metabolic dysfunction in NAFLD. Mol. Metab. 50: 101115.
    Pubmed KoreaMed CrossRef
  23. Meroni M, Longo M, Dongiovanni P. 2019. The role of probiotics nonalcoholic fatty liver disease: a new insight into therapeutic strategies. Nutrients 11: 2642.
    Pubmed KoreaMed CrossRef
  24. Park SY, Choi JW, On DN, Kim DP, Yoon SY, Jang WJ, et al. 2023. Anti-obesity potential through regulation of carbohydrate uptake and gene expression in intestinal epithelial cells by the probiotics Lactiplantibacillus plantarum MGEL20154 from fermented food. J. Microbiol. Biotechnol. 33: 621-633.
    Pubmed KoreaMed CrossRef
  25. Polyzos SA, Kountouras J, Mantzoros CS. 2019. Obesity and nonalcoholic fatty liver disease: from pathophysiology to therapeutics. Metabolism 92: 82-97.
    Pubmed CrossRef
  26. Kim JW, Lee YS, Seol DJ, Cho IJ, Ku SK, Choi JS, et al. 2018. Anti-obesity and fatty liver-preventing activities of Lonicera caerulea in high-fat diet-fed mice. Int. J. Mol. Med. 42: 3047-3064.
    CrossRef
  27. Hadizadeh F, Faghihimani E, Adivi P. 2017. Nonalcoholic fatty liver disease: diagnostic biomarkers. World Gastrointest. Pathophysiol. 15: 11-26.
    Pubmed KoreaMed CrossRef
  28. Draijer L, Benninga M, Koot B. 2019. Pediatric NAFLD: an overview and recent developments in diagnostics and treatment. Expert Rev. Gastrolenterol. Hepatol. 13: 447-461.
    Pubmed CrossRef
  29. Fang C, Pan J, Qu N, Lei Y, Han J, Zhang J, Han D. 2022. The AMPK pathway in fatty liver disease. Front. Physiol. 13: 970292.
    Pubmed KoreaMed CrossRef
  30. Moslehi A, Hamidi-zad Z. 2018. Role of SREBPs in liver diseases: a mini-review. J. Clin. Transl. Hepatol. 6: 332-338.
    Pubmed KoreaMed CrossRef
  31. Kim HI, Kim JK, Kim JY, Jang SE, Han MJ, Kim DH. 2019. Lactobacillus plantarum LC27 and Bifidobacterium longum LC67 simultaneously alleviated HFD-induced colitis, endotoxemia, liver steatosis, and obesity in mice. Nutr. Res. 67: 78-89.
    Pubmed CrossRef
  32. Lee E, Jung SR, Lee SY, Lee NK, Paik HD, Lin SI. 2018. Lactobacillus plantarum strain Ln4 attenuates diet-induced obesity, insulin resistance, and changes in hepatic mRNA levels associated with glucose and lipid metabolism. Nutrients 10: 643.
    Pubmed KoreaMed CrossRef
  33. Bauche IB, El Mkadem SA, Pottier AM, Senou M, Many MC, Rezsohazy R, et al. 2007. Overexpression of adiponectin targeted to adipose tissue in transgenic mice: Impaired adipocyte differentiation. Endocrinology 148: 1539-1549.
    Pubmed CrossRef
  34. Fabbrini E, Magkos F. 2015. Hepatic steatosis as a marker of metabolic dysfunction. Nutrients 7: 4995-5019.
    Pubmed KoreaMed CrossRef