Michael Hunter, MD on Medika Life

Artificial Intelligence, Microbiome, and Predicting Liver Disease

“The development of full artificial intelligence could spell the end of the human race….It would take off on its own, and re-design itself at an ever increasing rate. Humans, who are limited by slow biological evolution, couldn’t compete, and would be superseded.” — Stephen Hawking

CAN WE USE YOUR GUT MICROBIOME as an indicator of future health? The answer may be yes, according to a recent report suggesting we can use the microbiome as a health compass.

An international team led by the Leibniz Institute for Natural Product Research and Infection Biology-Hans Knöll Institute (Germany) discovered that the human microbiome could indicate the risk of developing nonalcoholic fatty liver disease.

Today, we quickly look at the microbiome before turning to the new study results.

The microbiome

If you want a quick primer on the human microbiome, please check out this short audio by scientist Julie Segre, Ph.D.:MicrobiomeMicrobiome. The microbiome is the collection of all microorganisms, bacteria, fungi and viruses. Well, we used to think…www.genome.gov

In summary, your gut microbiome is all the microbes in your intestines, which act as another organ.

Altogether, these microbes may weigh as much as five pounds. They function as an extra organ in your body and play a huge role in your health.

Photo by julien Tromeur on Unsplash

“The development of full artificial intelligence could spell the end of the human race….It would take off on its own, and re-design itself at an ever increasing rate. Humans, who are limited by slow biological evolution, couldn’t compete, and would be superseded.”

— Stephen Hawking

Non-alcoholic fatty liver disease

Alternative names for non-alcoholic fatty liver disease include fatty liver, steatosis, non-alcoholic steatohepatitis, and NASH.

Nonalcoholic fatty liver disease (NAFLD) is an umbrella term for various liver conditions affecting people who drink little to no alcohol. As the name implies, the main characteristic of NAFLD is too much fat stored in liver cells.

NAFLD affects up to 25 percent of the global population. For some individuals, undetected non-alcoholic fatty liver disease can lead to liver scarring, cancer, or failure.

Symptoms of advanced scarring (cirrhosis) may include:

Non-alcoholic fatty liver disease typically causes no symptoms. If symptoms occur, they may include general fatigue or discomfort in the upper right abdomen.

Some individuals with NAFLD develop nonalcoholic steatohepatitis (NASH), an aggressive form of fatty liver disease. With NASH, liver inflammation may progress to advanced scarring (cirrhosis) and liver failure. This damage is similar to the damage caused by heavy alcohol use.

Photo by Azmaan Baluch on Unsplash

Symptoms may include

  • Abdominal swelling (ascites)
  • Enlarged blood vessels just beneath the skin’s surface
  • Enlarged spleen
  • Red palms
  • Yellowing of the skin and eyes (jaundice)

Risk factors for non-alcoholic liver disease

NAFLD results from more than normal fat deposits in the liver. Experts don’t know why some people build up fat in the liver while others do not.

Things that may put you at risk include any of the following:

  • Being overweight or obese. The more overweight you are, the higher the risk.
  • Pre-diabetes (insulin resistance).
  • Type 2 diabetes.
  • High cholesterol or high triglycerides.
  • High blood pressure.

Other risk factors include rapid weight loss and poor diet, gastric bypass surgery, bowel disease, and certain medicines, such as calcium channel blockers and some cancer drugs. NAFLD also occurs in individuals with no known risk factors.

Gut microbiome and fatty liver disease prediction

Let’s look at how researchers developed a model to predict a disease course based on the gut’s microbial composition.

Increasing evidence suggests an interplay between the gut microbiome and nonalcoholic fatty liver disease (NAFLD). The role of the microbiome in the early detection of the condition remains unclear.

In this context, scientists evaluated 1,200 individuals in a community-based cohort. At the study start, no subject had liver disease. The researchers analyzed blood and stool samples.

The researchers followed the subjects for 4.6 years. When re-examined, 90 of the subjects had developed nonalcoholic fatty liver disease. They compared the samples of the affected individuals with a control group of 90 individuals who did not have NAFLD at baseline or the follow-up visit.

After finding subtle differences in the samples from four years prior, the group developed a microbiome-based model to predict NAFLD with 80 percent accuracy.

Photo by Andrea De Santis on Unsplash

Machine learning to predict fatty liver disease

The research team created a machine learning model — a computer model trained to recognize specific patterns in a dataset. The model can then use these patterns to analyze new datasets and predict nonalcoholic fatty liver disease for these researchers. The complex process spanned over three years. Voila, a successful tool for predicting nonalcoholic fatty liver disease.

The researchers validated their results using patient data from Europe and the United States. Next, they aim to conduct the study internationally and use artificial intelligence to integrate even larger data sets into the study.

My take: Non-alcoholic fatty liver disease

Given that nonalcoholic fatty liver is irreversible (and sometimes leads to liver cancer), early identification is helpful to counteract the condition’s natural history.

NAFLD is a largely silent disease, so kudos to the brilliant researchers for opening the door to early detection. A study author offers that microbiome-based diagnostics will reach clinical practice in the next ten years.

For now, you may reduce your risk of developing non-alcoholic fatty liver disease with these strategies:

  • Maintain a healthy weight.
  • Eat a healthy diet.
  • Exercise regularly.
  • Limit alcohol consumption.
  • Use medicines properly.

Thank you for joining me.

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Michael Hunter, MD
I received an undergraduate degree from Harvard, a medical degree from Yale, and trained in radiation oncology at the University of Pennsylvania. I practice radiation oncology in the Seattle area.

Michael Hunter, MD

I received an undergraduate degree from Harvard, a medical degree from Yale, and trained in radiation oncology at the University of Pennsylvania. I practice radiation oncology in the Seattle area.

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