Gut microbiome and metabolic-associated fatty liver disease: Current status and potential applications

Abstract

Metabolic-associated fatty liver disease (MAFLD) is one of the most common chronic liver diseases worldwide. In recent years, the occurrence rate of MAFLD has been on the rise, mainly due to lifestyle changes, high-calorie diets, and imbalanced dietary structures, thereby posing a threat to human health and creating heavy social and economic burdens. With the development of 16S sequencing and integrated multi-omics analysis, the role of the gut microbiota (GM) and its metabolites in MAFLD has been further recognized. The GM plays a role in digestion, energy metabolism, vitamin synthesis, the prevention of pathogenic bacteria colonisation, and immunoregulation. The gut-liver axis is one of the vital links between the GM and the liver. Toxic substances in the intestine can enter the liver through the portal vascular system when the intestinal barrier is severely damaged. The liver also influences the GM in various ways, such as bile acid circulation. The gut-liver axis is essential in maintaining the body’s normal physiological state and plays a role in the onset and prognosis of many diseases, including MAFLD. This article reviews the status of the GM and MAFLD and summarizes the GM characteristics in MAFLD. The relationship between the GM and MAFLD is discussed in terms of bile acid circulation, energy metabolism, micronutrients, and signalling pathways. Current MAFLD treatments targeting the GM are also listed.

Keywords: Metabolic-associated fatty liver disease; Gut microbiota; Current status; Application

Core Tip: Metabolic-associated fatty liver disease (MAFLD) is a highly prevalent metabolic disease worldwide. In this review, we provide an overview of the current status and potential applications of the gut microbiota (GM) in MAFLD, focusing on key aspects such as bile acid circulation, energy metabolism, and microelement disorder, as well as signal pathways and GM metabolites implicated in MAFLD development and treatments, with a particular emphasis on targeting the microbiome.