Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
Shanghai center of Thyroid diseases, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
Rev Endocr Metab Disord. 2023 Dec;24(6):1189-1204. doi: 10.1007/s11154-023-09843-z. Epub 2023 Oct 16.
Non-alcoholic fatty liver disease (NAFLD) is by far the most prevalent form of liver disease worldwide. It's also the leading cause of liver-related hospitalizations and deaths. Furthermore, there is a link between obesity and NAFLD risk. A projected 25% of the world's population grieves from NAFLD, making it the most common chronic liver disorder. Several factors, such as obesity, oxidative stress, and insulin resistance, typically accompany NAFLD. Weight loss, lipid-lowering agents, thiazolidinediones, and metformin help prominently control NAFLD. Interestingly, pre-clinical studies demonstrate gut microbiota's potential causal role in NAFLD. Increased intestinal permeability and unhindered transport of microbial metabolites into the liver are the major disruptions due to gut microbiome dysbiosis, contributing to the development of NAFLD by dysregulating the gut-liver axis. Hence, altering the pathogenic bacterial population using probiotics, prebiotics, synbiotics, and fecal microbiota transplantation (FMT) could benefit patients with NAFLD. Therefore, it is crucial to acknowledge the importance of microbiota-mediated therapeutic approaches for NAFLD and comprehend the underlying mechanisms that establish a connection between NAFLD and gut microbiota. This review provides a comprehensive overview of the affiliation between dysbiosis of gut microbiota and the progress of NAFLD, as well as the potential benefits of prebiotic, probiotic, synbiotic supplementation, and FMT in obese individuals with NAFLD.
非酒精性脂肪性肝病（NAFLD）是目前全球最普遍的肝脏疾病。它也是与肝脏相关的住院和死亡的主要原因。此外，肥胖与 NAFLD 风险之间存在关联。预计全球有 25%的人口患有 NAFLD，使其成为最常见的慢性肝脏疾病。几种因素，如肥胖、氧化应激和胰岛素抵抗，通常伴随着 NAFLD。减肥、降脂药物、噻唑烷二酮类和二甲双胍有助于显著控制 NAFLD。有趣的是，临床前研究表明肠道微生物群在 NAFLD 中具有潜在的因果作用。由于肠道微生物群失调导致肠道通透性增加和微生物代谢产物不受阻碍地进入肝脏，是主要的破坏因素，通过调节肠道-肝脏轴导致 NAFLD 的发展。因此，通过使用益生菌、益生元、合生元和粪便微生物移植（FMT）改变致病性细菌群体可能使 NAFLD 患者受益。因此，必须认识到微生物介导的治疗方法对 NAFLD 的重要性，并了解建立 NAFLD 与肠道微生物群之间联系的潜在机制。这篇综述全面概述了肠道微生物群失调与 NAFLD 进展之间的关联，以及在肥胖的 NAFLD 患者中补充益生元、益生菌、合生元和 FMT 的潜在益处。
