Clin Mol Hepatol.  2021 Jan;27(1):22-43. 10.3350/cmh.2020.0129.

The role of the gut microbiome and diet in the pathogenesis of non-alcoholic fatty liver disease

Affiliations
  • 1Department of Chemical Pathology, Southampton General Hospital, University Hospital Southampton, Southampton, UK
  • 2Department of Nutrition and Metabolism, Faculty of Medicine, University of Southampton, Southampton, UK
  • 3Southampton National Institute for Health Research Biomedical Research Centre, Southampton General Hospital, University Hospital Southampton, Southampton, UK

Abstract

Non-alcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease, with a prevalence that is increasing in parallel with the global rise in obesity and type 2 diabetes mellitus. The pathogenesis of NAFLD is complex and multifactorial, involving environmental, genetic and metabolic factors. The role of the diet and the gut microbiome is gaining interest as a significant factor in NAFLD pathogenesis. Dietary factors induce alterations in the composition of the gut microbiome (dysbiosis), commonly reflected by a reduction of the beneficial species and an increase in pathogenic microbiota. Due to the close relationship between the gut and liver, altering the gut microbiome can affect liver functions; promoting hepatic steatosis and inflammation. This review summarises the current evidence supporting an association between NAFLD and the gut microbiome and dietary factors. The review also explores potential underlying mechanisms underpinning these associations and whether manipulation of the gut microbiome is a potential therapeutic strategy to prevent or treat NAFLD.

Keyword

Non-alcoholic fatty liver disease; Gastrointestinal microbiome; Dysbiosis; Diet
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