Martínez-Montoro José Ignacio, Kuchay Mohammad Shafi, Balaguer-Román Andrés, Martínez-Sánchez María Antonia, Frutos María Dolores, Fernández-García José Carlos, Ramos-Molina Bruno
Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Institute of Biomedical Research in Malaga (IBIMA), Faculty of Medicine, University of Malaga, Malaga, Spain.
Division of Endocrinology and Diabetes, Medanta - The Medicity Hospital, Gurugram, Haryana, India.
Obes Rev. 2022 Feb;23(2):e13367. doi: 10.1111/obr.13367. Epub 2021 Nov 2.
Nonalcoholic fatty liver disease (NAFLD) is increasing in parallel with the rising prevalence of obesity, leading to major health and socioeconomic consequences. To date, the most effective therapeutic approach for NAFLD is weight loss. Accordingly, bariatric surgery (BS), which produces marked reductions in body weight, is associated with significant histopathological improvements in advanced stages of NAFLD, such as nonalcoholic steatohepatitis (NASH) and liver fibrosis. BS is also associated with substantial taxonomical and functional alterations in gut microbiota, which are believed to play a significant role in metabolic improvement after BS. Interestingly, gut microbiota and related metabolites may be implicated in the pathogenesis of NAFLD through diverse mechanisms, including specific microbiome signatures, short chain fatty acid production or the modulation of one-carbon metabolism. Moreover, emerging evidence highlights the potential association between gut microbiota changes after BS and NASH resolution. In this review, we summarize the current knowledge on the relationship between NAFLD severity and gut microbiota, as well as the role of the gut microbiome and related metabolites in NAFLD improvement after BS.
非酒精性脂肪性肝病（NAFLD）的患病率随着肥胖率的上升而同步增加，导致了重大的健康和社会经济后果。迄今为止，NAFLD最有效的治疗方法是减重。因此，能显著减轻体重的减肥手术（BS）与NAFLD晚期（如非酒精性脂肪性肝炎（NASH）和肝纤维化）的显著组织病理学改善相关。BS还与肠道微生物群的大量分类学和功能改变有关，这些改变被认为在BS后的代谢改善中起重要作用。有趣的是，肠道微生物群及其相关代谢产物可能通过多种机制参与NAFLD的发病过程，包括特定的微生物组特征、短链脂肪酸的产生或一碳代谢的调节。此外，新出现的证据强调了BS后肠道微生物群变化与NASH缓解之间的潜在关联。在这篇综述中，我们总结了目前关于NAFLD严重程度与肠道微生物群之间关系的知识，以及肠道微生物组及其相关代谢产物在BS后NAFLD改善中的作用。
