Enterotype-stratified gut microbial signatures in MASLD and cirrhosis based on integrated microbiome data

The Prevotella-dominated(ET-P) group exhibited a 33% higher cirrhosis rate than the Bacteroides-dominated(ET-B) group. Unique microbial signatures were identified: <i>Escherichia albertii</i> and <i>Veillonella nakazawae</i> were associated with cirrhosis in ET-B, while <i>Prevotella copri</i> was linked to MASLD. In ET-P, <i>Prevotella hominis</i> and <i>Clostridium saudiense</i> were significantly associated with cirrhosis. Functional analysis revealed reduced biosynthesis of fatty acids, proteins, and short-chain fatty acids (SCFAs), coupled with increased lipopolysaccharide(LPS) production and altered secondary bile acid metabolism in MASLD and cirrhosis patients. There were significant microbial and functional differences across enterotypes in MASLD and cirrhosis progression, providing critical insights for developing personalized microbiome-targeted interventions to mitigate liver disease progression.