Abstract

Metabolism-associated fatty liver disease (MAFLD) is a multifaceted disease that involves complex interactions between various organs, including the gut and heart. It is defined by hepatic lipid accumulation and is related to metabolic dysfunction, obesity, and diabetes. Understanding the intricate interplay of the gut-liver-heart crosstalk is crucial for unraveling the complexities of MAFLD and developing effective treatment and prevention strategies. The gut-liver crosstalk participates in the regulation of the metabolic and inflammatory processes through host-microbiome interactions. Gut microbiota have been associated with the development and progression of MAFLD, and its dysbiosis contributes to insulin resistance, inflammation, and oxidative stress. Metabolites derived from the gut microbiota enter the systemic circulation and influence both the liver and heart, resulting in the gut-liver-heart axis playing an important role in MAFLD. Furthermore, growing evidence suggests that insulin resistance, endothelial dysfunction, and systemic inflammation in MAFLD may contribute to an increased risk of cardiovascular disease (CVD). Additionally, the dysregulation of lipid metabolism in MAFLD may also lead to cardiac dysfunction and heart failure. Overall, the crosstalk between the liver and heart involves a complex interplay of molecular pathways that contribute to the development of CVD in patients with MAFLD. This review emphasizes the current understanding of the gut-liver-heart crosstalk as a foundation for optimizing patient outcomes with MAFLD.

MeSH

Liver Diseases, Insulin Resistance, Insulin, Heart, Non-Alcoholic Fatty Liver Disease, Cardiovascular Diseases, Liver, Food, Fatty Liver, Gastrointestinal Microbiome, Microbiota

Cited by

• The Liver in Heart Failure: From Biomarkers to Clinical Risk. Int J Mol Sci, 2023
• The mediating role of insulin resistance in the association between inflammatory score and MAFLD: NHANES 2017-2018. Immun Inflamm Dis, 2024
• Orchestration of Gut-Liver-Associated Transcription Factors in MAFLD: From Cross-Organ Interactions to Therapeutic Innovation. Biomedicines, 2025
• Research hotspots and trends in gut microbiota and nonalcoholic fatty liver disease: A bibliometric study. World J Hepatol, 2025
• Mechanisms and Therapeutic Strategies for MAFLD Targeting TLR4 Signaling Pathways. J Innate Immun, 2024
• Targeting Metabolic Diseases: The Role of Nutraceuticals in Modulating Oxidative Stress and Inflammation. Nutrients, 2024
• The Interplay between Liver and Adipose Tissue in the Onset of Liver Diseases: Exploring the Role of Vitamin Deficiency. Cells, 2024
• From Childhood Obesity to Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and Hyperlipidemia Through Oxidative Stress During Childhood. Metabolites, 2025
• Metformin in Antiviral Therapy: Evidence and Perspectives. Viruses, 2025
• Metabolic dysfunction-associated steatotic liver disease and cardiovascular risk: a comprehensive review. Cardiovasc Diabetol, 2024
• Remnant cholesterol, a potential risk factor of metabolic dysfunction-associated fatty liver disease. Nutr Metab (Lond), 2025
• Increased BMD in SLD Patients Without Advanced Hepatic Fibrosis: Evidence From the NHANES 2017-2020 Database. Can J Gastroenterol Hepatol, 2025
• Therapeutic potential of Glycyrrhiza glabra L. extract and atorvastatin in HFD-induced MAFLD: in vitro and in vivo exploration. 3 Biotech, 2025
• Identification of EGR1 as a Key Diagnostic Biomarker in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) Through Machine Learning and Immune Analysis. J Inflamm Res, 2025
• Endothelial Dysfunction: Redox Imbalance, NLRP3 Inflammasome, and Inflammatory Responses in Cardiovascular Diseases. Antioxidants (Basel), 2025
• Electrocardiographic P-Wave Indices in Metabolic Dysfunction-Associated Fatty Liver Disease and Their Relationship to Hepatic Fibrosis Risk. J Clin Med, 2025
• The association between lifelines diet score and metabolic associated fatty liver disease: a case-control study. Front Nutr, 2025