Nonalcoholic Fatty Liver Disease and the Gut-Liver Axis: Exploring an Undernutrition Perspective

Nonalcoholic fatty liver disease (NAFLD) is a chronic condition affecting one quarter of the global population. Although primarily linked to obesity and metabolic syndrome, undernutrition and the altered (dysbiotic) gut microbiome influence NAFLD progression. Both undernutrition and NAFLD prevalence are predicted to considerably increase, but how the undernourished gut microbiome contributes to hepatic pathophysiology remains far less studied. Here, we present undernutrition conditions with fatty liver features, including kwashiorkor and micronutrient deficiency. We then review the gut microbiota-liver axis, highlighting key pathways linked to NAFLD progression within both overnutrition and undernutrition. To conclude, we identify challenges and collaborative possibilities of emerging multiomic research addressing the pathology and treatment of undernourished NAFLD.

Automated summary

Nonalcoholic fatty liver disease is a common chronic condition associated with obesity and metabolic syndrome, but it is also influenced by undernutrition and dysbiotic gut microbiome. The relationship between undernutrition and NAFLD is not well studied. This review discusses the features of fatty liver in undernutrition conditions and the gut microbiota-liver axis, highlighting key pathways in NAFLD progression under both overnutrition and undernutrition. The challenges and collaborative possibilities in emerging multiomic research for the pathology and treatment of undernourished NAFLD are also identified.