Gut microbiota, vitamin metabolism, and metabolic dysfunction-associated liver disease: mechanisms, interactions, and therapeutic strategies

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a chronic liver disorder closely associated with metabolic disturbances and characterized by a complex pathogenesis, further complicated by the lack of effective treatments. Increasing evidence suggests that the interplay between gut microbiota and vitamin metabolism plays a pivotal role in the development and progression of MASLD. The gut microbiota contributes to the synthesis, activation, and utilization of vitamins, which, in turn, modulate the composition and function of the gut microbial community. This bidirectional regulatory relationship influences lipid metabolism and inflammatory responses, thereby offering a promising therapeutic target for MASLD. This review aims to systematically summarize the mechanisms by which gut microbiota dysbiosis and aberrant vitamin metabolism drive MASLD pathogenesis and to explore the targeting of gut microbiota and vitamin homeostasis as a potential strategy for the prevention and treatment of metabolic liver diseases.