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The severity of nonalcoholic fatty liver disease is associated with gut dysbiosis and shift in the metabolic function of the gut microbiota
Open accessAbstract
Several animal studies have emphasized the role of gut microbiota in nonalcoholic fatty liver disease (NAFLD). However, data about gut dysbiosis in human NAFLD remain scarce in the literature, especially studies including the whole spectrum of NAFLD lesions. We aimed to evaluate the association between gut dysbiosis and severe NAFLD lesions, that is, nonalcoholic steatohepatitis (NASH) and fibrosis, in a well‐characterized population of adult NAFLD. Fifty‐seven patients with biopsy‐proven NAFLD were enrolled. Taxonomic composition of gut microbiota was determined using 16S ribosomal RNA gene sequencing of stool samples. Thirty patients had F0/F1 fibrosis stage at liver biopsy (10 with NASH), and 27 patients had significant F≥2 fibrosis (25 with NASH). Bacteroides abundance was significantly increased in NASH and F≥2 patients, whereas Prevotella abundance was decreased. Ruminococcus abundance was significantly higher in F≥2 patients. By multivariate analysis, Bacteroides abundance was independently associated with NASH and Ruminococcus with F≥2 fibrosis. Stratification according to the abundance of these two bacteria generated three patient subgroups with increasing severity of NAFLD lesions. Based on imputed metagenomic profiles, Kyoto Encyclopedia of Genes and Genomes pathways significantly related to NASH and fibrosis F≥2 were mostly related to carbohydrate, lipid, and amino acid metabolism. Conclusion: NAFLD severity associates with gut dysbiosis and a shift in metabolic function of the gut microbiota. We identified Bacteroides as independently associated with NASH and Ruminococcus with significant fibrosis. Thus, gut microbiota analysis adds information to classical predictors of NAFLD severity and suggests novel metabolic targets for pre‐/probiotics therapies. (H epatology 2016;63:764–775)
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“Boursier et al. found that NAFLD severity was associated with gut dysbiosis and a shift in the metabolic function of the gut microbiota with Bacteroides independently associated with the occurrence of NASH, and Ruminococcus with the presence of significant fibrosis [230].”
From Gut-pancreas-liver Axis as a target for treatment of NAFLD/NASH (2020) · cites this paper as [230]
In the citing paper
“Likewise, a number of studies have demonstrated alterations of the gut microbiota in earlier stages of liver disease 35,36 as well as in animal models16,31.”
From The gut microbiome and liver cancer: mechanisms and clinical translation (2017) · cites this paper as [36]
In the citing paper
“However, bacterial abundance patterns were not consistent between studies, with levels of Bacteroidetes increased in some studies36,56 and decreased in other studies57,58, and a substantial overlap with healthy individuals59.”
From The gut microbiome and liver cancer: mechanisms and clinical translation (2017) · cites this paper as [36]
In the citing paper
“Interestingly, Ruminococcaceae have been found to be enriched in samples from fibrotic patients with NAFLD/NASH36,37, supporting their role in the pathogenesis of other chronic liver diseases that also associate with impaired intestinal barrier function.”
From Cholestasis induced by bile duct ligation promotes changes in the intestinal microbiome in mice (2019) · cites this paper as [37]
In the citing paper
“As well, in those studies it was shown that NALFD/NASH in patients associated with increased abundance of Bacteroides abundance36,37.”
From Cholestasis induced by bile duct ligation promotes changes in the intestinal microbiome in mice (2019) · cites this paper as [37]
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BackgroundInfluentialGut Microbiota in Human Adults with Type 2 Diabetes Differs from Non-Diabetic Adults
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BackgroundInfluentialNonalcoholic Fatty Liver, Steatohepatitis, and the Metabolic Syndrome
Marchesini, G., Bugianesi, E., Forlani, G., Cerrelli, F., Lenzi, M., Manini, R., Natale, S., Vanni, E., Villanova, N., Melchionda, N., et al. (2003) · Hepatology · doi:10.1053/jhep.2003.50161 · Cited by 2,728 · cited 4×
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InfluentialInflammasome-mediated dysbiosis regulates progression of NAFLD and obesity
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“As previously described,((27)) the presence of the MetS was strongly associated with more severe NAFLD lesions (Fig.”
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Walker, A. W., Ince, J., Duncan, S. H., Webster, L. M., Holtrop, G., Ze, X., Brown, D., Stares, M. D., Scott, P., Bergerat, A., et al. (2011) · The ISME Journal · doi:10.1038/ismej.2010.118 · Cited by 1,632 · cited 4×
“Ruminococcus are able to ferment complex carbohydrates, such as cellulose, pectine, resistant starch,((44,45)) and are acetate and propionate producers.”
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BackgroundInfluentialInterplay between lipids and branched-chain amino acids in development of insulin resistance
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Ruminococcus bromii is a keystone species for the degradation of resistant starch in the human colon
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BackgroundInfluentialIntestinal microbiota determines development of non-alcoholic fatty liver disease in mice
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Schnabl, B., & Brenner, D. A. (2014) · Gastroenterology · doi:10.1053/j.gastro.2014.01.020 · Cited by 971 · cited 2×
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“2-fold higher risk of developing liver fibrosis (LF).((3)) Several other factors that influence the course of the disease have been identified, such as epigenetics,((4)) hormonal status,((5)) or nutrition.”
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BackgroundInfluentialSelf-citationEndpoints and clinical trial design for nonalcoholic steatohepatitis
Sanyal, A. J., Brunt, E. M., Kleiner, D. E., Kowdley, K. V., Chalasani, N., Lavine, J. E., Ratziu, V., & McCullough, A. J. (2011) · Hepatology · doi:10.1002/hep.24376 · Cited by 763 · cited 2×
“As recently recommended,((20)) NASH was defined as the presence of each of the three following conditions: steatosis grade 1; lobular”
BackgroundIntestinal microbiota in patients with nonalcoholic fatty liver disease
Mouzaki, M., Comelli, E. M., Arendt, B. M., Bonengel, J., Fung, S. K., Fischer, S. E., McGilvray, I. D., & Allard, J. P. (2013) · Hepatology · doi:10.1002/hep.26319 · Cited by 749 · cited 10×
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“AST, IU/L 40 (32-59) 36 (30-43) 32 (20-44) 56 (37-71) 0.”
Non-alcoholic fatty liver disease: The mist gradually clears
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BackgroundRelationship Between Methylome and Transcriptome in Patients With Nonalcoholic Fatty Liver Disease
Murphy, S. K., Yang, H., Moylan, C. A., Pang, H., Dellinger, A., Abdelmalek, M. F., Garrett, M. E., Ashley–Koch, A., Suzuki, A., Tillmann, H. L., et al. (2013) · Gastroenterology · doi:10.1053/j.gastro.2013.07.047 · Cited by 391 · cited 1×
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“pyrosequencing) are available in the literature.((16-18)) In addition, because liver biopsy was not available in all patients to phenotype liver lesions, underdiagnosis of NASH was possible, especially in obese patients.”
BackgroundResultInfluentialUtilisation of Mucin Glycans by the Human Gut Symbiont Ruminococcus gnavus Is Strain-Dependent
Crost, E. H., Tailford, L. E., Gall, G. L., Fons, M., Henrissat, B., & Juge, N. (2013) · PLoS ONE · doi:10.1371/journal.pone.0076341 · Cited by 325 · cited 5×
“GGT, IU/L 80 (40-124) 71 (39-127) 53 (29-117) 93 (60-159) 0.”
BackgroundInfluentialManipulating the gut microbiota to maintain health and treat disease
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Dysbiosis contributes to fibrogenesis in the course of chronic liver injury in mice
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BackgroundInfluentialBiological significance of short-chain fatty acid metabolism by the intestinal microbiome
Puertollano, E., Kolida, S., & Yaqoob, P. (2014) · Current Opinion in Clinical Nutrition & Metabolic Care · doi:10.1097/mco.0000000000000025 · Cited by 242 · cited 12×
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BackgroundInfluentialGut Microbiota Composition Modifies Fecal Metabolic Profiles in Mice
Zhao, Y., Wu, J., Li, J. V., Zhou, N., Tang, H., & Wang, Y. (2013) · Journal of Proteome Research · doi:10.1021/pr400263n · Cited by 228 · cited 5×
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BackgroundInfluentialBile acid levels are increased in the liver of patients with steatohepatitis
Aranha, M. M., Cortez-Pinto, H., Costa, A., da Silva, I. B. M., Camilo, M., de Moura, M. D., & Rodrigues, C. (2008) · European Journal of Gastroenterology and Hepathology · doi:10.1097/meg.0b013e3282f4710a · Cited by 209 · cited 5×
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BackgroundInfluentialPhenotyping the effect of diet on non-alcoholic fatty liver disease
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“The latter are known to promote insulin resistance,(43) and insulin resistance increases the risk for NASH.”
BackgroundResultInfluentialImplication of Gut Microbiota in Nonalcoholic Fatty Liver Disease
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“Recent animal studies have placed the gut microbiota as a potentially important player in the pathogenesis of NAFLD.((14,15)) However, data linking gut dysbiosis with the severity of NAFLD remain poorly documented in humans.”
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“GGT, IU/L 80 (40-124) 71 (39-127) 53 (29-117) 93 (60-159) 0.”
BackgroundInfluentialEarly Diet Impacts Infant Rhesus Gut Microbiome, Immunity, and Metabolism
O’Sullivan, A. M., He, X., McNiven, E. M. S., Haggarty, N. W., Lönnerdal, B. L., & Slupsky, C. M. (2013) · Journal of Proteome Research · doi:10.1021/pr4001702 · Cited by 101
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BackgroundInfluential
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Metadata
- Authors
- Boursier, J., Mueller, O., Barret, M., Machado, M., Fizanne, L., Araujo‐Perez, F., Guy, C. D., Seed, P. C., Rawls, J. F., David, L. A., Hunault, G., Oberti, F., Calès, P., & Diehl, A. M.
- Affiliations
- Centre Hospitalier Universitaire d'Angers (FR)
- Duke University (US)
- Institut de Recherche en Horticulture et Semences (FR)
- Duke Medical Center (US)
- HIFIH Laboratory, UPRES 3859, SFR 4208,LUNAM University,Angers,France
- Department of Pediatrics,Duke University Medical Center,Durham,NC
- Corresponding author
- Boursier, Jérôme
- ORCID
- Venue
- Hepatology
- Published
- 2016-01-13
- Volume
- 63
- Issue
- 3
- Pages
- 764-775
- ISSN
- 0270-9139 (ISSN-L)
- 1527-3350
- PMC
- PMC4975935
- OpenAlex
- W2178380008
- Cited by
- 1,483
- References
- 51
- Citations by year
- 2026: 105 · 2025: 162 · 2024: 180 · 2023: 190 · 2022: 161 · 2021: 191 · 2020: 154 · 2019: 132 · 2018: 91 · 2017: 74 · 2016: 37
- FWCI
- 29.69
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- HAL (submittedVersion)
- Funders
- Association Française pour l'Etude du Foie
- Société Nationale Française de Gastro-Entérologie
- National Institutes of Health
- National Institute of Diabetes and Digestive and Kidney Diseases (R01-DK106633, R56DK106633, R01DK053792)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
- Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
- Keywords
- non-alcoholic fatty liver disease, nonalcoholic steatohepatitis, liver fibrosis, gut dysbiosis, gut microbiota, Bacteroides, Ruminococcus, Prevotella, NAFLD severity, carbohydrate metabolism, lipid metabolism, amino acid metabolism, probiotics
- MeSH terms
- Gastrointestinal Microbiome, Aged, Feces, Female, Fibrosis, Humans, Liver, Male, Middle Aged, Metagenome, Dysbiosis, Non-alcoholic Fatty Liver Disease
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