Abstract
The gut microbiota plays a role in nonalcoholic fatty liver disease (NAFLD), but data about gut dysbiosis in Asians with NAFLD remains scarce. We analyzed the differences in fecal microbiota between adults with and without NAFLD. This cross-sectional study examined adults with histology-proven NAFLD (25 nonalcoholic fatty liver (NAFL) patients, 25 nonalcoholic steatohepatitis (NASH) patients, and 25 living liver donors (healthy controls)). The taxonomic composition of the gut microbiota was determined by 16S ribosomal RNA gene sequencing of stool samples. The NAFL and NASH groups showed lower total bacterial diversity and richness than the controls. NAFLD patients had higher levels of the phylum Bacteroidetes and lower levels of Firmicutes than controls. The genus Ruminococcaceae UCG-010, family Ruminococcaceae, order Clostridiales, and class Clostridia were less abundant in patients with NAFL or NASH than healthy individuals. The lipopolysaccharide biosynthesis pathway was differentially enriched in the NASH group. This study examined the largest number of Asian patients with biopsy-proven NAFL and NASH in terms of dysbiosis of the gut microbiota in NAFLD patients. NAFLD patients had higher levels of Bacteroidetes and lower levels of Firmicutes. These results are different from research from western countries and could provide different targets for therapies by region.
Highlights
Nonalcoholic fatty liver disease (NAFLD) is defined by the presence of at least 5% hepatic steatosis with a lack of common causes of secondary hepatic fat accumulation, such as excessive alcohol consumption, chronic viral hepatitis, autoimmune hepatitis, or long-term use of steatosis-inducing medications
A total of 75 subjects were enrolled in this study, including 25 health controls, as well as 25 nonalcoholic fatty liver disease (NAFL) patients and 25 nonalcoholic steatohepatitis (NASH) patients (NAFLD group)
We have demonstrated the altered have established a relationship between the gut microbiota and nonalcoholic fatty liver disease (NAFLD), but there have been few diversity and composition of the gut microbiota of patients with NAFL and NASH in comparison to studies on Asians, and they have yielded inconsistent results
Summary
Nonalcoholic fatty liver disease (NAFLD) is defined by the presence of at least 5% hepatic steatosis with a lack of common causes of secondary hepatic fat accumulation, such as excessive alcohol consumption, chronic viral hepatitis, autoimmune hepatitis, or long-term use of steatosis-inducing medications. NAFLD is the most common form of chronic liver disease in many industrialized counties, and globally, almost one-quarter of adults show excessive hepatic fat accumulation [1,2]. The condition constitutes a spectrum ranging from hepatic steatosis (nonalcoholic fatty liver (NAFL)) to steatosis with hepatocellular injury and possibly fibrosis (non-alcoholic steatohepatitis (NASH)). NASH is the aggressive form of NAFLD. It leads to liver fibrosis and cirrhosis and hepatocellular carcinoma, which increase liver-related morbidity and mortality [3]. NAFLD was thought to be predominantly driven by obesity in the context of genetic susceptibility
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