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Atherosclerosis and metabolic dysfunction-associated steatotic liver disease (MASLD) both belong to chronic diseases. Lipid metabolism disorders and inflammatory responses are the common pathological and physiological mechanisms associated with these diseases. The occurrence of both diseases is closely related to dietary factors and lifestyle. Numerous studies have confirmed that excessive sugar intake accelerates chronic inflammation and insulin resistance, disrupts lipid metabolism, and promotes oxidative stress, thereby damaging health.
With the improvement of health awareness, aspartame and acesulfame-K, as calorie-free artificial sweeteners, are widely used as sugar substitutes. In May 2023, the latest guidelines of the World Health Organization (WHO) recommended that non-nutritive sweeteners should not be used to control weight or prevent chronic diseases. It is worth noting that there is still controversy in the scientific community regarding the specific effects of aspartame and acesulfame-K, two commonly used sweeteners, on cardiovascular diseases and MASLD.
In November 2025, the team ofWENG JIAN PING/XU SUO WEN from the First Hospital Affiliated to University of Science and Technology of China published an article titled "Non-Nutritive Artificial Sweeteners Aspartame and Acesulfame-K Ameliorate Metabolic Dysfunction-Associated Steatotic Liver Disease in Male Ldlr−/− Mice" in iNew Medicine. The study found that after consuming aspartame or acesulfame-K， the body weight of male Ldlr−/− mice receiving the AMLN (amylin liver NASH model) diet decreased， and the liver steatosis and fibrosis were also improved. However， after 20 weeks of acesulfame-K intake， the area of atherosclerotic plaques in the mice increased， but no statistically significant increase was found in the aspartame intake group. The analysis of the mouse liver transcriptome revealed changes in lipid metabolism and inflammation-related pathways. The above results indicate that both of these sweeteners can improve MASLD in the atherosclerosis-MASLD comorbidity model， but acesulfame-K may slightly increase atherosclerosis.
Original link:https://onlinelibrary.wiley.com/doi/10.1002/inm3.70005
