Gut Flora in the Development and Progression of Nonalcoholic Fatty Liver Disease

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the United States. There is an increased prevalence noted among individuals with morbid obesity and type 2 diabetes. The prevalence of NAFLD is expected to continue to rise given the current global obesity epidemic. The pathogenesis of NAFLD is not clearly understood, but there is emerging evidence to suggest that the gut microbiota plays an important role. The gut microbiota is involved in dietary energy extraction, bile acid metabolism, endogenous alcohol production, choline metabolism, modulation of the host’s immune system and alteration of intestinal permeability. This review focuses on the potential pathways through which the gut microbiota is linked to the development and progression of NAFLD. Figure 1 is our proposed schematic representation of the role of the gut microbiota in NAFLD.