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LDHA expression is directly regulated by transcription factors such as c-Myc and hypoxia-inducible factor 1 (HIF-1), with the latter further increasing lactate production by blocking pyruvate entry into mitochondria [65, 66]

Studies consistently find that, compared with healthy controls, the -diversity (e.g., Shannon index, Chao1 index) of gut flora in liver disease patients is significantly reduced, and -diversity (community structure) shifts significantly, indicating that the gut microbial ecosystem tends toward simplification and disorder in disease states

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Recognizing these triggers can help individuals make lifestyle changes to prevent future occurrences