The interaction between the gut microbiota and dietary carbohydrates in nonalcoholic fatty liver disease

Exp Mol Med. 2021 May;53(5):809-822. doi: 10.1038/s12276-021-00614-x. Epub 2021 May 20.

Abstract

Imbalance between fat production and consumption causes various metabolic disorders. Nonalcoholic fatty liver disease (NAFLD), one such pathology, is characterized by abnormally increased fat synthesis and subsequent fat accumulation in hepatocytes1,2. While often comorbid with obesity and insulin resistance, this disease can also be found in lean individuals, suggesting specific metabolic dysfunction2. NAFLD has become one of the most prevalent liver diseases in adults worldwide, but its incidence in both children and adolescents has also markedly increased in developed nations3,4. Progression of this disease into nonalcoholic steatohepatitis (NASH), cirrhosis, liver failure, and hepatocellular carcinoma in combination with its widespread incidence thus makes NAFLD and its related pathologies a significant public health concern. Here, we review our understanding of the roles of dietary carbohydrates (glucose, fructose, and fibers) and the gut microbiota, which provides essential carbon sources for hepatic fat synthesis during the development of NAFLD.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Biomarkers
  • Carbohydrate Metabolism
  • Comorbidity
  • Dietary Carbohydrates / metabolism*
  • Disease Susceptibility*
  • Fructose / metabolism
  • Gastrointestinal Microbiome*
  • Gene Expression Regulation, Enzymologic
  • Host Microbial Interactions*
  • Humans
  • Insulin Resistance
  • Lipid Metabolism
  • Liver / metabolism
  • Liver / pathology
  • Non-alcoholic Fatty Liver Disease / etiology*
  • Non-alcoholic Fatty Liver Disease / metabolism*
  • Non-alcoholic Fatty Liver Disease / pathology

Substances

  • Biomarkers
  • Dietary Carbohydrates
  • Fructose