非酒精性脂肪性肝病与肠道菌群失调新观点

非酒精性脂肪性肝病（NAFLD）在世界范围内患病率逐渐升高，“二次打击学说”发病机制已经被认可，但是具体的病理生理学发病机制还不完全清楚。近期，已有大量研究的新观点来解释肠道菌群在 NAFLD 发病机制中的作用，包括调节肠粘膜通透性、低水平炎症反应和免疫平衡，调节饮食胆碱代谢，调节胆汁酸代谢和增加细菌产生的内源性乙醇等。这些因素在分子水平上解释了肠道菌群如何促发 NAFLD 的发生，并进一步诱导其向非酒精性脂肪性肝炎（NASH）进展。

Perspectives in gut microbiota in non-alcoholic fatty liver diseases

Non-alcoholic fatty liver diseases （NAFLD） has an increasing worldwide prevalence. A‘two-hit’ mechanism has been accepted,however,its pathogenesis remains to be clarified. Recently,some new findings about gut microbiota in NAFLD have emerged. It might be involved in gut permeability,low-grade inflammation and immune inbalance,and it is believed that it modulates dietary choline metabolism,regulates bile acid metabolism and produces endogenous ethanol. All of these factors are molecular mechanisms by which the microbiota can induce NAFLD or has some roles in the process from NAFLD to overt non-alcoholic steatohepatitis. This review summarizes the main literature findings about the relationships between gut microbiota and NAFLD.