Emerging Role of the Gut Microbiome in Nonalcoholic Fatty Liver Disease: From Composition to Function

&NA; The gut microbiome, a diverse microbial community in the gastrointestinal tract, plays a pivotal role in the maintenance of health. The gut microbiome metabolizes dietary and host‐derived molecules to produce bioactive metabolites, which have a wide array of effects on host metabolism and immunity. ‘Dysbiosis’ of the gut microbiome, commonly considered as perturbation of microbiome diversity and composition, has been associated with intestinal and extra‐intestinal diseases, including nonalcoholic fatty liver disease (NAFLD). A number of endogenous and exogenous factors, such as nutritional intake and xenobiotic exposure, can alter the gut microbiome. We will review the evolving methods for studying the gut microbiome and how these profiling techniques have been utilized to further our understanding of the gut microbial community composition and functional potential in the clinical spectrum of NAFLD. We will highlight microbiome‐host interactions that may contribute to the pathogenesis of NAFLD, with a primary focus on mechanisms related to the metabolic output of the gut microbiome. Finally, we will discuss potential therapeutic implications of the gut microbiome in NAFLD.

• Publication year

  2019

• Venue

  Clinical Gastroenterology and Hepatology

• Publication date

  2019-01-01

• Fields of study

  Biology, Medicine, Environmental Science

• Identifiers
  DOI 10.1016/j.cgh.2018.08.065PMID 30196156PMCID PMC6314895
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• Current understanding of the human microbiome

  2018cited by this paper
• Bile acid–microbiota crosstalk in gastrointestinal inflammation and carcinogenesis

  2018cited by this paper
• Hepatocellular Carcinoma Is Associated With Gut Microbiota Profile and Inflammation in Nonalcoholic Fatty Liver Disease

  2018cited by this paper
• Link between gut‐microbiome derived metabolite and shared gene‐effects with hepatic steatosis and fibrosis in NAFLD

  2018cited by this paper
• Restoration of a healthy intestinal microbiota normalizes portal hypertension in a rat model of nonalcoholic steatohepatitis

  2018cited by this paper
• Extensive impact of non-antibiotic drugs on human gut bacteria

  2018cited by this paper
• Molecular Phenomics and Metagenomics of Hepatic Steatosis in Non-Diabetic Obese Women

  2018cited by this paper
• JKB-121 in patients with nonalcoholic steatohepatitis: A phase 2 double blind randomized placebo control study

  2018cited by this paper
• Connection Between BMI-Related Plasma Metabolite Profile and Gut Microbiota

  2018cited by this paper
• Best practices for analysing microbiomes

  2018cited by this paper
• Metatranscriptome of human fecal microbial communities in a cohort of adult men

  2018cited by this paper
• Nonalcoholic fatty liver disease is associated with dysbiosis independent of body mass index and insulin resistance

  2018cited by this paper
• Interactions between Bacteria and Bile Salts in the Gastrointestinal and Hepatobiliary Tracts

  2017cited by this paper
• Bile Acid Uptake Transporters as Targets for Therapy

  2017cited by this paper
• Uncovering the trimethylamine-producing bacteria of the human gut microbiota

  2017cited by this paper
• The gut mycobiome of the Human Microbiome Project healthy cohort

  2017cited by this paper
• Microbial metabolites in health and disease: Navigating the unknown in search of function

  2017cited by this paper
• Role of Probiotics in the Treatment of Nonalcoholic Fatty Liver Disease: A Meta-analysis

  2017cited by this paper
• The gut microbiome and liver cancer: mechanisms and clinical translation

  2017cited by this paper
• Blood Trimethylamine-N-Oxide Originates from Microbiota Mediated Breakdown of Phosphatidylcholine and Absorption from Small Intestine

  2017cited by this paper
• Gut microbiota dysbiosis in patients with non-alcoholic fatty liver disease.

  2017cited by this paper
• Gut microbiota profiling of pediatric nonalcoholic fatty liver disease and obese patients unveiled by an integrated meta‐omics‐based approach

  2017cited by this paper
• Gut microbiome composition in lean patients with NASH is associated with liver damage independent of caloric intake: A prospective pilot study.

  2017cited by this paper
• Improvement of Insulin Sensitivity after Lean Donor Feces in Metabolic Syndrome Is Driven by Baseline Intestinal Microbiota Composition.

  2017cited by this paper
• Gut Microbiome-Based Metagenomic Signature for Non-invasive Detection of Advanced Fibrosis in Human Nonalcoholic Fatty Liver Disease.

  2017cited by this paper
• Crosstalk between Bile Acids and Gut Microbiota and Its Impact on Farnesoid X Receptor Signalling

  2017cited by this paper
• Suppressed hepatic bile acid signalling despite elevated production of primary and secondary bile acids in NAFLD

  2017cited by this paper
• Intestinal Short Chain Fatty Acids and their Link with Diet and Human Health

  2016cited by this paper
• Ethanol Production by Selected Intestinal Microorganisms and Lactic Acid Bacteria Growing under Different Nutritional Conditions

  2016cited by this paper
• Human gut microbes impact host serum metabolome and insulin sensitivity

  2016cited by this paper
• Disentangling the effects of type 2 diabetes and metformin on the human gut microbiota

  2016cited by this paper
• Deficiency of intestinal mucin-2 protects mice from diet-induced fatty liver disease and obesity.

  2016cited by this paper
• Profile of Gut Microbiota Associated With the Presence of Hepatocellular Cancer in Patients With Liver Cirrhosis.

  2016cited by this paper
• Altered Fecal Microbiota Correlates with Liver Biochemistry in Nonobese Patients with Non-alcoholic Fatty Liver Disease

  2016cited by this paper
• Bile Acids and Dysbiosis in Non-Alcoholic Fatty Liver Disease

  2016cited by this paper
• Bifidobacteria and lactobacilli in the gut microbiome of children with non-alcoholic fatty liver disease: which strains act as health players?

  2016cited by this paper
• Loss of Junctional Adhesion Molecule A Promotes Severe Steatohepatitis in Mice on a Diet High in Saturated Fat, Fructose, and Cholesterol.

  2016cited by this paper
• The severity of nonalcoholic fatty liver disease is associated with gut dysbiosis and shift in the metabolic function of the gut microbiota

  2016cited by this paper
• The Human Intestinal Microbiome in Health and Disease.

  2016cited by this paper
• Consequences of bile salt biotransformations by intestinal bacteria

  2016cited by this paper
• A purified membrane protein from Akkermansia muciniphila or the pasteurized bacterium improves metabolism in obese and diabetic mice

  2016cited by this paper
• Obesity changes the human gut mycobiome

  2015cited by this paper
• Akkermansia muciniphila inversely correlates with the onset of inflammation, altered adipose tissue metabolism and metabolic disorders during obesity in mice

  2015cited by this paper
• Inulin-type fructans modulate intestinal Bifidobacterium species populations and decrease fecal short-chain fatty acids in obese women.

  2015cited by this paper
• Altered Bile Acid Metabolome in Patients with Nonalcoholic Steatohepatitis

  2015cited by this paper
• Farnesoid X nuclear receptor ligand obeticholic acid for non-cirrhotic, non-alcoholic steatohepatitis (FLINT): a multicentre, randomised, placebo-controlled trial.

  2015cited by this paper
• Intestinal farnesoid X receptor signaling promotes nonalcoholic fatty liver disease.

  2015cited by this paper
• Intestinal Microbiota Composition Modulates Choline Bioavailability from Diet and Accumulation of the Proatherogenic Metabolite Trimethylamine-N-Oxide

  2015cited by this paper
• Dysbiosis gut microbiota associated with inflammation and impaired mucosal immune function in intestine of humans with non-alcoholic fatty liver disease

  2015cited by this paper
• Short-chain fatty acids in control of body weight and insulin sensitivity

  2015cited by this paper
• Regulation of obesity-related insulin resistance with gut anti-inflammatory agents.

  2015cited by this paper
• Disentangling the effects of type 2 diabetes and metformin on the human gut microbiota

  2015cited by this paper
• Insulin resistance alters hepatic ethanol metabolism: studies in mice and children with non-alcoholic fatty liver disease

  2015cited by this paper
• Altered gut microbial energy and metabolism in children with non-alcoholic fatty liver disease.

  2015cited by this paper
• Proton pump inhibitors alter the composition of the gut microbiota

  2015cited by this paper
• Effects of targeted delivery of propionate to the human colon on appetite regulation, body weight maintenance and adiposity in overweight adults

  2014cited by this paper
• An integrated catalog of reference genes in the human gut microbiome

  2014cited by this paper
• A Taxonomic Signature of Obesity in the Microbiome? Getting to the Guts of the Matter

  2014cited by this paper
• Interactions between the intestinal microbiome and liver diseases.

  2014cited by this paper
• Intestinal microbial metabolism of phosphatidylcholine and cardiovascular risk.

  2013cited by this paper
• Characterization of gut microbiomes in nonalcoholic steatohepatitis (NASH) patients: A connection between endogenous alcohol and NASH

  2013cited by this paper
• Biomarkers for Type 2 Diabetes and Impaired Fasting Glucose Using a Nontargeted Metabolomics Approach

  2013cited by this paper
• Effects of Sodium Butyrate and Its Synthetic Amide Derivative on Liver Inflammation and Glucose Tolerance in an Animal Model of Steatosis Induced by High Fat Diet

  2013cited by this paper
• Richness of human gut microbiome correlates with metabolic markers

  2013cited by this paper
• Fecal microbiome and volatile organic compound metabolome in obese humans with nonalcoholic fatty liver disease.

  2013cited by this paper
• Molecular Characterization of the Fecal Microbiota in Patients with Nonalcoholic Steatohepatitis – A Longitudinal Study

  2013cited by this paper
• A high-fat diet is associated with endotoxemia that originates from the gut.

  2012cited by this paper
• Transfer of intestinal microbiota from lean donors increases insulin sensitivity in individuals with metabolic syndrome.

  2012cited by this paper
• Molecular analysis of gut microbiota in obesity among Indian individuals

  2012cited by this paper
• Choline metabolism provides novel insights into nonalcoholic fatty liver disease and its progression

  2012cited by this paper
• Inflammasome-mediated dysbiosis regulates progression of NAFLD and obesity

  2012cited by this paper
• Obesity-associated gut microbiota is enriched in Lactobacillus reuteri and depleted in Bifidobacterium animalis and Methanobrevibacter smithii

  2011cited by this paper
• Metabolite profiles and the risk of developing diabetes

  2011cited by this paper
• Association between composition of the human gastrointestinal microbiome and development of fatty liver with choline deficiency.

  2011cited by this paper
• Role of Alcohol Metabolism in Non-Alcoholic Steatohepatitis

  2010cited by this paper
• Microbiota and SCFA in Lean and Overweight Healthy Subjects

  2010cited by this paper
• Increased intestinal permeability and tight junction alterations in nonalcoholic fatty liver disease

  2009cited by this paper
• Antibiotics protect against fructose-induced hepatic lipid accumulation in mice: role of endotoxin.

  2008cited by this paper
• Metabolic profiling reveals a contribution of gut microbiota to fatty liver phenotype in insulin-resistant mice

  2006cited by this paper
• THE PREVENTION BY CHOLINE OF LIVER CIRRHOSIS IN RATS ON HIGH FAT, LOW PROTEIN DIETS.

  1941cited by this paper

• MetALD: A narrative review of the clinical and molecular landscape of reclassifying steatotic liver disease.

  2026cites this paper
• Phellodendron amurense Rupr. Polysaccharides protects against diabetic nephropathy via alteration of PI3K/GSK-3β/Nrf2/TGF-β/Smad signaling pathway and gut microbiota

  2026cites this paper
• Microbial Biomarkers for the Prevention and Diagnosis of Alcoholic Liver Disease.

  2026cites this paper
• Bile acid and microbiome interactions in the developing child.

  2025cites this paper
• Deciphering the role of Dietary Modifications and Gut Dysbiosis in Non-Alcoholic Fatty Liver Disease

  2025cites this paper
• Microbiota-derived H2S induces c-kit+ cDC1 autophagic cell death and liver inflammation in metabolic dysfunction-associated steatohepatitis

  2025cites this paper
• Iron overload exacerbates metabolic dysfunction-associated steatohepatitis via the microbiota-gut-liver axis through lipopolysaccharide-mediated Akr1b8 activation.

  2025cites this paper
• From dysbiosis to therapy: Shared gut microbial signatures and targeted interventions across liver, heart and brain disorders

  2025cites this paper
• N-acetyl-phenylalanine induces hepatic steatosis in MASLD by disrupting ER-mitochondria calcium coupling and mitochondrial lipid oxidation

  2025cites this paper
• Early-Life Nutritional Determinants of Pediatric MASLD

  2025cites this paper
• Gut microbiota in hepatic encephalopathy: a 3PM-guided three-tier health strategy

  2025cites this paper
• Intestinal NLRP3 Deficiency Exacerbates MASLD in Male Mice via Reduced Butyrate Production

  2025cites this paper
• Sex and gender differences in MASLD: pathophysiological mechanisms, clinical implications, and future directions

  2025cites this paper
• Smilax china L. Extract Alleviates Metabolic-Associated Fatty Liver Disease by Regulating Gut Microbiota and Bile Acid Metabolism

  2025cites this paper
• The role of gut microbiota augmentation in managing non-alcoholic fatty liver disease: an in-depth umbrella review of meta-analyses with grade assessment

  2024cites this paper
• Envisioning how to advance the MASH field

  2024cites this paper
• Sex differences in metabolic dysfunction-associated steatotic liver disease: a narrative review

  2024cites this paper
• Sex differences in mortality and liver‐related events in non‐alcoholic fatty liver disease: A systematic review and meta‐analysis

  2024cites this paper
• Associations of Fecal Microbiota with Ectopic Fat in African Caribbean Men

  2024cites this paper
• In Vitro Influence of Specific Bacteroidales Strains on Gut and Liver Health Related to Metabolic Dysfunction-Associated Fatty Liver Disease

  2024cites this paper
• Long-term outcomes and risk modifiers of metabolic dysfunction-associated steatotic liver disease between lean and non-lean populations

  2024cites this paper
• Changes in intestinal permeability and gut microbiota following diet-induced weight loss in patients with metabolic dysfunction-associated steatohepatitis and liver fibrosis

  2024cites this paper
• Therapeutic Role of Probiotics Against Environmental-Induced Hepatotoxicity: Mechanisms, Clinical Perspectives, Limitations, and Future

  2024cites this paper
• Global Epidemiology of Cirrhosis in Women

  2024cites this paper
• Investigating the efficacy of acupuncture in treating patients with metabolic-associated fatty liver disease: a protocol for a randomised controlled clinical trial

  2024cites this paper
• Beneficial Effects of the Ketogenic Diet on Nonalcoholic Fatty Liver Disease (NAFLD/MAFLD)

  2024cites this paper
• Study on the molecular mechanisms of rifaximin in the treatment of non‑alcoholic steatohepatitis based on the Helicobacter‑DCA‑Fxr‑Hnf1α signalling pathway

  2024cites this paper
• Pathogenesis and research progress of nonalcoholic fatty liver disease/nonalcoholic steatohepatitis

  2024cites this paper
• Disparities in Metabolic Dysfunction-Associated Steatotic Liver Disease Prevalence, Diagnosis, Treatment, and Outcomes: A Narrative Review

  2024cites this paper
• Non-invasive ventilation restores the gut microbiota in rats with acute heart failure

  2024cites this paper
• Optimizing cardiometabolic risk in people living with human immunodeficiency virus: A deep dive into an important risk enhancer

  2024cites this paper
• Acupuncture influences multiple diseases by regulating gut microbiota

  2024cites this paper
• A High-Fat Diet Increases the Characteristics of Gut Microbial Composition and the Intestinal Damage Associated with Non-Alcoholic Fatty Liver Disease

  2023cites this paper
• The gut-liver axis links the associations between serum carotenoids and non-alcoholic fatty liver in a 7.8-year prospective study

  2023cites this paper
• Polycystic Ovarian Syndrome: a Risk Factor for Cardiovascular Disease

  2023cites this paper
• Ultra-processed food consumption and non-alcoholic fatty liver disease, metabolic syndrome and insulin resistance: A systematic review

  2023cites this paper
• From Non-Alcoholic Steatohepatitis (NASH) to Hepatocellular Carcinoma (HCC): Epidemiology, Incidence, Predictions, Risk Factors, and Prevention

  2023cites this paper
• Current Status of Research on Cardiovascular Risk in Patients with Non-Alcoholic Fatty Liver Disease

  2023cites this paper
• Therapeutics for Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD)

  2023cites this paper
• Dual Role of Pregnane X Receptor in Nonalcoholic Fatty Liver Disease.

  2023cites this paper
• Which Comes First, Nonalcoholic Fatty Liver Disease or Arterial Hypertension?

  2023cites this paper
• The intersection between alcohol-related liver disease and nonalcoholic fatty liver disease

  2023cites this paper
• Fecal Microbiota Transplantation for Weight and Glycemic Control of Obesity as Well as the Associated Metabolic Diseases: Meta-Analysis and Comprehensive Assessment

  2023cites this paper
• Modulation of the Microbiome-Fat-Liver Axis by Lactic Acid Bacteria: A Potential Alleviated Role in High-Fat-Diet-Induced Obese Mice.

  2023cites this paper
• Gut microbiota: a magical multifunctional target regulated by medicine food homology species.

  2023cites this paper
• Multidimensional landscape of non‐alcoholic fatty liver disease‐related disease spectrum uncovered by big omics data: Profiling evidence and new perspectives

  2023cites this paper
• The role of microbiome in the pathogenesis of oral-gut-liver axis between periodontitis and nonalcoholic fatty liver disease

  2023cites this paper
• Acupuncture improved hepatic steatosis in HFD-induced NAFLD rats by regulating intestinal microbiota

  2023cites this paper
• Extensive identification of serum metabolites related to microbes in different gut locations and evaluating their associations with porcine fatness

  2023cites this paper
• Insights from shotgun metagenomics into bacterial species and metabolic pathways associated with NAFLD in obese youth

  2022cites this paper
• Relationship Between Hepatic Gene Expression, Intestinal Microbiota, and Inferred Functional Metagenomic Analysis in NAFLD

  2022cites this paper
• NASH and the Gut Microbiome: Implications for New Therapies

  2022cites this paper
• Current Status and Future Therapeutic Options for Fecal Microbiota Transplantation

  2022cites this paper
• Gut metagenome‐derived signature predicts hepatic decompensation and mortality in NAFLD‐related cirrhosis

  2022cites this paper
• Gender Differences in Nonalcoholic Fatty Liver Disease

  2022cites this paper
• Role and Regulation of Hepatobiliary ATP-Binding Cassette Transporters during Chemical-Induced Liver Injury

  2022cites this paper
• Effects of oily fish and its fatty acid intake on non-alcoholic fatty liver disease development among South Korean adults

  2022cites this paper
• Shared Mechanisms between Cardiovascular Disease and NAFLD

  2022cites this paper
• The Gut Microbiome and Ferroptosis in MAFLD

  2022cites this paper
• Microbiota diversity in nonalcoholic fatty liver disease and in drug-induced liver injury.

  2022cites this paper
• Effect of Fecal Microbiota Transplantation on Non-Alcoholic Fatty Liver Disease: A Randomized Clinical Trial

  2022cites this paper
• Gut dysbiosis and metabolic diseases.

  2022cites this paper
• Changes in the gut microbiome associated with liver stiffness improvement in nonalcoholic steatohepatitis

  2022cites this paper
• Role and regulation of hepatobiliary ATP-Binding Cassette ( ABC ) transporters during chemical-induced liver injury

  2022cites this paper
• Role and regulation of hepatobiliary ATP-Binding Cassette ( ABC ) transporters during chemical-induced liver injury

  2022cites this paper
• Role and regulation of hepatobiliary ATP-Binding Cassette ( ABC ) transporters during chemical-induced liver injury

  2022cites this paper
• Impact of non-invasive biomarkers on hepatology practice: Past, present and future.

  2022cites this paper
• MAFLD under the lens: the role of gut microbiota

  2022cites this paper
• Penthorum chinense Pursh. extract attenuates non-alcholic fatty liver disease by regulating gut microbiota and bile acid metabolism in mice.

  2022cites this paper
• Prolonged Use of Proton Pump Inhibitors and Risk of Type 2 Diabetes: Results From a Large Population-Based Nested Case-Control Study

  2022cites this paper
• Role and regulation of hepatobiliary ATP-Binding Cassette ( ABC ) transporters during chemical-induced liver injury

  2022cites this paper
• Pathophysiological Mechanisms in Non-Alcoholic Fatty Liver Disease: From Drivers to Targets

  2021cites this paper
• Chronic Pelvic Pain and Pelvic Dysfunctions: Assessment and Multidisciplinary Approach

  2021cites this paper
• Effects of goat milk enriched with oligosaccharides on microbiota structures, and correlation between microbiota and short-chain fatty acids in mouse large intestine.

  2021cites this paper
• Effect of green-Mediterranean diet on intrahepatic fat: the DIRECT PLUS randomised controlled trial

  2021cites this paper
• NAFLD and Cardiovascular Diseases: Epidemiological, Mechanistic and Therapeutic Considerations

  2021cites this paper
• Understanding the Effects of Gut Microbiota Dysbiosis on Nonalcoholic Fatty Liver Disease and the Possible Probiotics Role: Recent Updates

  2021cites this paper
• PNPLA3 Single Nucleotide Polymorphism Prevalence and Association with Liver Disease in a Diverse Cohort of Persons Living with HIV

  2021cites this paper
• Mining Gut Microbiota From Bariatric Surgery for MAFLD

  2021cites this paper
• Mechanisms and disease consequences of nonalcoholic fatty liver disease.

  2021cites this paper
• Gut Microbiome and Liver Cancer

  2021cites this paper
• Role of Glucagon-Like Peptide-1 Receptor Agonists in the Management of Non-Alcoholic Steatohepatitis: A Clinical Review Article

  2021cites this paper
• Gut microbiota as an emerging therapeutic avenue for the treatment of non-alcoholic fatty liver disease.

  2021cites this paper
• Mechanistic and physiological approaches of fecal microbiota transplantation in the management of NAFLD

  2021cites this paper
• Diet, Microbiome, and Cancer Immunotherapy—A Comprehensive Review

  2021cites this paper
• Gut-Hepatic Relationship: From Disorders of the Gut Microbiota to Hepatocellular Carcinoma

  2021cites this paper
• Gastrointestinal Physiology and Aging

  2021cites this paper
• Role of microbiota and related metabolites in gastrointestinal tract barrier function in NAFLD

  2021cites this paper
• Abnormal Metabolism in the Progression of Nonalcoholic Fatty Liver Disease to Hepatocellular Carcinoma: Mechanistic Insights to Chemoprevention

  2021influential citation
• Intestinal dysbiosis in nonalcoholic fatty liver disease (NAFLD): focusing on the gut–liver axis

  2021cites this paper
• Clearing Steatosis Prior to Liver Surgery for Colorectal Metastasis: A Narrative Review and Case Illustration

  2021cites this paper
• Blood manganese and nonalcoholic fatty liver disease: A cohort-based case-control study.

  2021cites this paper
• Gut Microbiota Dysbiosis in Non-alcoholic Fatty Liver Disease

  2021cites this paper
• Metabolomics as a Tool to Investigate HIV/TB Co-Infection

  2021cites this paper
• Review article: insights into the bile acid‐gut microbiota axis in intestinal failure‐associated liver disease—redefining the treatment approach

  2021cites this paper
• Promising diagnostic biomarkers of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis: From clinical proteomics to microbiome

  2021cites this paper
• Hepatitis

  2020cites this paper
• Human microbiome is a diagnostic biomarker in hepatocellular carcinoma.

  2020cites this paper
• Non‐alcoholic Fatty Liver Disease

  2020cites this paper
• Gut microbiota and human NAFLD: disentangling microbial signatures from metabolic disorders

  2020cites this paper