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ORIGINAL RESEARCH ARTICLE

Yinqi Tiaozhi Decoction ameliorates hepatic steatosis in metabolic dysfunction-associated fatty liver disease by regulating the miR-122-5p/FOXO3 axis to modulate lipid metabolism and oxidative stress

Liping Zhou1† ,  Yanfeng Huang2† ,  Feng Tian1* ,  Yingji Zhai3 ,  Xingbo Xiong3 ,  Weiqiao Chen3 ,  Xiaoliang Luo3 ,  Xinghua Chen2 ,  Zhao Zhang4 ,  Qiuping Zhao2 ,  Chun Guo2 ,  Yiyi Hu2,3*
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1 Department of Health Management Center, The Eighth Affiliated Hospital, Southern Medical University (The First People’s Hospital of Shunde, Foshan), Foshan, Guangdong , China
2 Department of Advanced Diagnostic and Treatment, The Eighth Affiliated Hospital, Southern Medical University (The First People’s Hospital of Shunde, Foshan), Foshan, Guangdong , China
3 Department of Gastroenterology, The Eighth Affiliated Hospital, Southern Medical University (The First People’s Hospital of Shunde, Foshan), Foshan, Guangdong , China
4 Center of Human Microecology Engineering and Technology of Guangdong Province, Guangzhou, Guangdong , China
†These authors contributed equally to this work.
EJMO, 026230263 https://doi.org/10.36922/EJMO026230263
Received: 7 June 2026 | Revised: 8 July 2026 | Accepted: 19 August 2026 | Published online: 10 September 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Introduction: Metabolic dysfunction-associated fatty liver disease (MAFLD) lacks targeted pharmacotherapies.

Objective: This study investigates whether Yinqi Tiaozhi Decoction (YQTZD) alleviates MAFLD via the miR-122-5p/forkhead box O3 (FOXO3) axis.

Methods: MAFLD was modeled using oleic acid–treated AML12 cells and rats fed a choline-deficient high-fat diet. The effects of YQTZD or YQTZD-containing serum on lipid accumulation, oxidative stress, inflammation, glucose metabolism, and miR-122-5p/FOXO3 expression were evaluated, and the role of miR-122-5p was further examined using mimic transfection.

Results: YQTZD-containing serum (YQTZD-CS) dose-dependently enhanced AML12 cell viability, reduced lipid accumulation (total cholesterol and triglycerides), and mitigated oxidative injury, as reflected by changes in superoxide dismutase, malondialdehyde, and glutathione peroxidase levels. MiR-122-5p downregulation and FOXO3 upregulation were observed alongside these protective effects, while miR-122-5p mimic transfection abolished YQTZD-CS’s protection. In choline-deficient high-fat diet-induced MAFLD rats, YQTZD improved body weight, glucose tolerance, and insulin sensitivity, while histopathological assessments confirmed marked attenuation of hepatic steatosis. It also reduced serum lipids, suppressed hepatic pro-inflammatory mediators (interleukin [IL]-6, tumor necrosis factor alpha, and IL-1β), and mitigated oxidative stress, alongside elevated glutamine synthetase activity and glutamine levels. Crucially, YQTZD consistently suppressed miR-122-5p and upregulated FOXO3 in vivo. Thus, YQTZD mitigates hepatic steatosis, oxidative damage, and inflammation in MAFLD, mechanistically linked to miR-122-5p downregulation-mediated FOXO3 upregulation.

Conclusion: This study underscores the translational promise of YQTZD and provides a mechanistic foundation for its future integration into clinical management of MAFLD.

Keywords
Metabolic dysfunction-associated fatty liver disease
Yinqi Tiaozhi Decoction
Oxidative stress
Lipid deposition
miR-122-5p
FOXO3
Funding
This work was supported by Scientific Research of the Guangdong Provincial Administration of Traditional Chinese Medicine (General Project) (No. 20241313); the Scientific Research Start Plan of Shunde Hospital, Southern Medical University (Key Project) (No. SRSP2023023); the Scientific Research Start Plan of Shunde Hospital, Southern Medical University (Independent Application Project) (No. SRSP2022004); and the Scientific and Technological Research of Self-funded in Foshan City (No. 2220001003924).
Conflict of interest
The authors have no relevant financial or non-financial interests to disclose.
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Eurasian Journal of Medicine and Oncology, Electronic ISSN: 2587-196X Print ISSN: 2587-2400, Published by AccScience Publishing
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