Fermented <i>Protaetia brevitarsis</i> Larvae Alleviates High-Fat Diet-Induced Non-Alcoholic Fatty Liver Disease in C57BL/6 Mice via Regulation of Lipid Accumulation and Inflammation

Non-alcoholic fatty liver disease (NAFLD), characterized by hepatic steatosis and hepatitis, is the most frequently encountered complication of type 2 diabetes mellitus (T2DM). Due to its hepatoprotective, anti-obesity, antioxidant, and anti-inflammatory effects, <i>Protaetia brevitarsis</i> (<i>P. brevitarsis</i>) larvae have been used as traditional medicine to treat liver diseases since ancient times. Therefore, this study was conducted to confirm the positive effect of fermented <i>P. brevitarsis</i> larvae (FPB) on NAFLD. The results showed that high-fat diet (HFD)-induced dysglycemia was improved by treatment with FPB as determined by testing for fasting blood glucose and oral glucose tolerance. The weight of liver and white adipose tissue and the levels of serum lipid, hepatotoxicity, and nephrotoxicity indicators were reduced by FPB. In addition, oxidative stress and mitochondrial dysfunction caused by HFD were improved by FPB. In a similar manner, HFD-induced hepatic steatosis was prevented by FPB through regulation of the AMP-activated protein kinase pathway and serum lipid profile. HFD-induced hepatitis and apoptosis were ameliorated by FPB via the nuclear factor-kappa B pathway and the B-cell lymphoma 2 protein family. In conclusion, this study suggests the potential for application of FPB as a prophylactic agent for treatment of NAFLD through suppression of lipid accumulation and inflammation in the liver.