Journal
NATURE REVIEWS GASTROENTEROLOGY & HEPATOLOGY
Volume 17, Issue 5, Pages 279-297Publisher
NATURE PORTFOLIO
DOI: 10.1038/s41575-020-0269-9
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Funding
- European Union [H2020-PHC-2014-634413]
- Innovative Medicines Initiative 2 Joint Undertaking [777377]
- European Union's Horizon 2020 research and innovation programme
- EFPIA
- FP7 Metacardis [HEALTH-F4-2012-305312]
- National support from French Investment for the Future (National Agency of Research)
- National support from French Investment for the Future (F-CRIN FORCE)
- National support from French Investment for the Future (Metagenopolis)
- National support from French Investment for the Future (ICAN)
- Bettencourt Schueller Fondation
- personal ZONMW-VIDI grant 2013 [016.146.327]
- Amsterdam UMC Fellowship grant
- Health Holland TKI-PPP grant
- Gilead Research scholarship grant
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Gut microbiota dysbiosis has been repeatedly observed in obesity and type 2 diabetes mellitus, two metabolic diseases strongly intertwined with non-alcoholic fatty liver disease (NAFLD). Animal studies have demonstrated a potential causal role of gut microbiota in NAFLD. Human studies have started to describe microbiota alterations in NAFLD and have found a few consistent microbiome signatures discriminating healthy individuals from those with NAFLD, non-alcoholic steatohepatitis or cirrhosis. However, patients with NAFLD often present with obesity and/or insulin resistance and type 2 diabetes mellitus, and these metabolic confounding factors for dysbiosis have not always been considered. Patients with different NAFLD severity stages often present with heterogeneous lesions and variable demographic characteristics (including age, sex and ethnicity), which are known to affect the gut microbiome and have been overlooked in most studies. Finally, multiple gut microbiome sequencing tools and NAFLD diagnostic methods have been used across studies that could account for discrepant microbiome signatures. This Review provides a broad insight into microbiome signatures for human NAFLD and explores issues with disentangling these signatures from underlying metabolic disorders. More advanced metagenomics and multi-omics studies using system biology approaches are needed to improve microbiome biomarkers. The gut microbiota has been linked to non-alcoholic fatty liver disease (NAFLD), but metabolic confounding factors, such as obesity and diabetes, complicate analysis. This Review provides a broad insight into microbiome signatures for human NAFLD and explores issues with disentangling them from underlying metabolic disorders.
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