Crude beetroot extract ameliorates metabolic-dysfunction associated steatotic liver disease by improving the MAS-activity score in an experimental rat model

The burden of metabolic-dysfunction associated steatotic liver disease (MASLD) has been rising. Targeted therapy is either expensive or unavailable. Beetroot, nonetheless, contains phytochemicals that have qualitatively been shown to deter the progression of MASLD. We sought, using stereology, to quantify the ameliorative potential of crude beetroot extract on the progression of induced MASLD. 45 rats were studied and grouped into three: Group 1 rats fed on a hyper-calorific diet; Group 2 rats fed on a hyper-calorific diet and crude beetroot extract at 200 mg/kg, while Group 3 rats were fed on standard rat chows. Five rats from groups 1 and 2 were euthanized at weeks 4, 8, 12, and 16, and blood samples were taken for biochemical analysis. The livers were then harvested and systematic uniform random sampling was used to select histological samples for processing. Images were taken and the Cavalieri principle of point counting employed to determine MASLD activity score (MAS) as listed: Steatosis scored 0 to 3; lobular inflammation scored 0 to 3 (foci/200X field) and ballooning, scored 0 to 2. A hyper-calorific diet resulted in hyperglycaemia, dyslipidaemia, and high triglyceride-glucose index, accompanied by a temporal increase in the severity of hepatocyte steatosis, ballooning and inflammation. The MAS increased with time and was highest at the 16th week for group 1 compared to group 2. Beetroot supplementation delayed hepatocyte ballooning (78.0% vs. 65.0%) and led to lower rates of moderate inflammation and severe steatosis. The accompanying biochemical markers also showed significant improved. Beetroot reduces the histological changes associated with induced MASLD by lowering the severity of several MAS components while significantly improving associated biochemical parameters.