The role of the gut microbiota in NAFLD

Jun 9, 2016Nature reviews. Gastroenterology & hepatology

How Gut Bacteria Are Linked to Non-Alcoholic Fatty Liver Disease

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Abstract

NAFLD is now the most common cause of liver disease in Western countries.

Dysbiosis is linked to the development of NAFLD, as shown by animal studies and patient observations.
Increased gut permeability due to dysbiosis allows harmful bacterial products to reach the liver, potentially causing inflammation and fibrosis.
A poor diet, in conjunction with dysbiosis, alters metabolism of food, resulting in heightened production of certain short-chain fatty acids and alcohol while depleting choline.
Changes in the gut microbiome may lead to gut motility issues, inflammation, and immune responses that could further damage the liver.
Dietary components and lifestyle choices may affect NAFLD severity by altering gut microbiota composition.

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NAFLD is now the most common cause of liver disease in Western countries. This Review explores the links between NAFLD, the metabolic syndrome, dysbiosis, poor diet and gut health. Animal studies in which the gut microbiota are manipulated, and observational studies in patients with NAFLD, have provided considerable evidence that dysbiosis contributes to the pathogenesis of NAFLD. Dysbiosis increases gut permeability to bacterial products and increases hepatic exposure to injurious substances that increase hepatic inflammation and fibrosis. Dysbiosis, combined with poor diet, also changes luminal metabolism of food substrates, such as increased production of certain short-chain fatty acids and alcohol, and depletion of choline. Changes to the microbiome can also cause dysmotility, gut inflammation and other immunological changes in the gut that might contribute to liver injury. Evidence also suggests that certain food components and lifestyle factors, which are known to influence the severity of NAFLD, do so at least in part by changing the gut microbiota. Improved methods of analysis of the gut microbiome, and greater understanding of interactions between dysbiosis, diet, environmental factors and their effects on the gut-liver axis should improve the treatment of this common liver disease and its associated disorders.

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The role of the gut microbiota in NAFLD

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