Department of Laboratory Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, the People's Republic of China.
Hepatol Commun. 2024 Feb 26;8(3). doi: 10.1097/HC9.0000000000000310. eCollection 2024 Mar 1.
Metabolic dysfunction-associated steatotic liver disease (MASLD), a replacement of the nomenclature employed for NAFLD, is the most prevalent chronic liver disease worldwide. Despite its high global prevalence, NAFLD is often under-recognized due to the absence of reliable noninvasive biomarkers for diagnosis and staging. Growing evidence suggests that the gut microbiome plays a significant role in the occurrence and progression of NAFLD by causing immune dysregulation and metabolic alterations due to gut dysbiosis. The rapid advancement of sequencing tools and metabolomics has enabled the identification of alterations in microbiome signatures and gut microbiota-derived metabolite profiles in numerous clinical studies related to NAFLD. Overall, these studies have shown a decrease in α-diversity and changes in gut microbiota abundance, characterized by increased levels of Escherichia and Prevotella, and decreased levels of Akkermansia muciniphila and Faecalibacterium in patients with NAFLD. Furthermore, bile acids, short-chain fatty acids, trimethylamine N-oxide, and tryptophan metabolites are believed to be closely associated with the onset and progression of NAFLD. In this review, we provide novel insights into the vital role of gut microbiome in the pathogenesis of NAFLD. Specifically, we summarize the major classes of gut microbiota and metabolic biomarkers in NAFLD, thereby highlighting the links between specific bacterial species and certain gut microbiota-derived metabolites in patients with NAFLD.
代谢相关脂肪性肝病（MAFLD），取代了非酒精性脂肪性肝病（NAFLD）的命名，是全球最常见的慢性肝病。尽管全球患病率很高，但由于缺乏可靠的非侵入性生物标志物用于诊断和分期，NAFLD 常常未被识别。越来越多的证据表明，肠道微生物组通过引起免疫失调和代谢改变，导致肠道菌群失调，在 NAFLD 的发生和进展中起重要作用。测序工具和代谢组学的快速发展，使人们能够在与 NAFLD 相关的众多临床研究中，鉴定出微生物组特征和肠道微生物衍生代谢物图谱的改变。总的来说，这些研究表明，NAFLD 患者的α多样性降低，肠道微生物丰度发生变化，表现为大肠杆菌和普雷沃氏菌水平升高，阿克曼氏菌和粪杆菌水平降低。此外，胆汁酸、短链脂肪酸、三甲胺 N-氧化物和色氨酸代谢物被认为与 NAFLD 的发病和进展密切相关。在这篇综述中，我们提供了关于肠道微生物组在 NAFLD 发病机制中重要作用的新见解。具体来说，我们总结了 NAFLD 中主要的肠道微生物群和代谢生物标志物，从而强调了特定细菌种类与 NAFLD 患者某些肠道微生物衍生代谢物之间的联系。
