Department of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Sciences, 61-701 Poznań, Poland.
Department of Internal Medicine, Metabolic Disorders, and Hypertension, Poznań University of Medical Sciences, 61-701 Poznań, Poland.
Int J Environ Res Public Health. 2021 Feb 8;18(4):1616. doi: 10.3390/ijerph18041616.
Non-alcoholic fatty liver disease (NAFLD) is a significant clinical and epidemiological problem that affects around 25% of the adult global population. A large body of clinical evidence highlights that NAFLD is associated with increased liver-related morbidity and mortality and an increased risk of cardiovascular disease, extrahepatic cancers, type 2 diabetes, and chronic kidney disease. Recently, a series of studies revealed the pivotal role of gut microbiota (GM) dysbiosis in NAFLD's pathogenesis. The GM plays an essential role in different metabolic pathways, including the fermentation of diet polysaccharides, energy harvest, choline regulation, and bile acid metabolism. One of the most critical factors in GM stabilization is the diet; therefore, nutritional therapyappearsto be a promising tool in NAFLD therapy. This paper aims to review the current knowledge regardingthe nutritional approach and its implications with GM and NAFLD treatment. We discuss the positive impact of probiotics, prebiotics, and symbiotics in a reverse dysbiosis state in NAFLD and show the potential beneficial effects of bioactive substances from the diet. The full description of the mechanism of action and comprehensive examination of the impact of nutritional interventions on GM modulation may, in the future, be a simple but essential tool supporting NAFLD therapy.
非酒精性脂肪性肝病(NAFLD)是一个重大的临床和流行病学问题,影响着全球约 25%的成年人。大量临床证据表明,NAFLD 与肝脏相关发病率和死亡率的增加以及心血管疾病、肝外癌症、2 型糖尿病和慢性肾脏病的风险增加有关。最近,一系列研究揭示了肠道微生物群(GM)失调在 NAFLD 发病机制中的关键作用。GM 在不同的代谢途径中发挥着重要作用,包括饮食多糖的发酵、能量收获、胆碱调节和胆汁酸代谢。GM 稳定的最重要因素之一是饮食;因此,营养疗法似乎是 NAFLD 治疗的一种有前途的工具。本文旨在综述目前关于营养方法及其与 GM 和 NAFLD 治疗关系的知识。我们讨论了益生菌、益生元和共生体在 NAFLD 中逆向失调状态下的积极影响,并展示了饮食中的生物活性物质的潜在有益作用。全面描述作用机制并综合检查营养干预对 GM 调节的影响,将来可能成为支持 NAFLD 治疗的一种简单但基本的工具。