Integrated Assessment of Gut Microbiota, Liver Function, and Metabolic Health Among Adolescents: Implications For Preventive Medicine

Abstract

Adolescence represents a critical developmental window during which disturbances in metabolic regulation may establish long-term trajectories toward obesity, insulin resistance, dyslipidemia, and fatty liver disease. Growing evidence implicates the gut microbiome as a key mediator of these processes through its effects on nutrient metabolism, intestinal barrier integrity, microbial metabolite production, bile acid signalling, inflammation, and hepatic lipid homeostasis. This review evaluates the interrelationship between gut microbiota, liver function, and metabolic health in adolescents and examines its relevance to preventive medicine. Peer-reviewed literature published between 2020 and 2026 addressing adolescent microbiome characteristics, hepatic dysfunction, metabolic abnormalities, associated mechanisms, and microbiome-targeted interventions was critically synthesised. Current evidence indicates that altered microbial diversity, taxonomic composition, and functional activity are associated with obesity, impaired glucose regulation, dyslipidemia, and hepatic steatosis. These relationships are further shaped by diet, adiposity, endocrine status, environmental exposures, and host susceptibility, emphasizing the multifactorial nature of the gut–liver–metabolic axis. Dietary modification and other microbiome-oriented approaches show preventive potential, but microbial biomarkers and targeted therapies remain insufficiently validated for routine clinical use. Integrating microbiome data with anthropometric, metabolic, and hepatic assessments may improve early risk stratification. Longitudinal and interventional studies are needed to establish causality and determine whether microbiome-informed prevention provides sustained clinical benefit beyond conventional lifestyle-based strategies.