Nonalcoholic fatty liver disease (NALFD) is now a leading cause of chronic liver disease worldwide, in part, as a consequence of rapidly rising levels of obesity and metabolic syndrome and is a major risk factor for cirrhosis, hepatocellular carcinoma, and liver-related mortality. From NAFLD stems a myriad of clinical challenges related to both diagnosis and management. A growing body of evidence suggests an intricate linkage between the gut microbiome and the pathogenesis of NAFLD. We highlight how our current knowledge of the gut-liver axis in NAFLD may be leveraged to develop gut microbiome-based personalized approaches for disease management, including its use as a non-invasive biomarker for diagnosis and staging, as a target for therapeutic modulation, and as a marker of drug response. We will also discuss current limitations of these microbiome-based approaches. Ultimately, a better understanding of microbiota-host interactions in NAFLD will inform the development of novel preventative strategies and precise therapeutic targets.

非酒精性脂肪性肝病（NALFD）现已成为全球慢性肝病的主要原因，部分原因是肥胖和代谢综合征水平迅速上升，并且是肝硬化、肝细胞癌和肝脏相关死亡的主要危险因素。NAFLD 带来了与诊断和治疗相关的无数临床挑战。越来越多的证据表明肠道微生物组与 NAFLD 发病机制之间存在复杂的联系。我们强调如何利用我们目前对 NAFLD 肠肝轴的了解来开发基于肠道微生物组的个性化疾病管理方法，包括将其用作诊断和分期的非侵入性生物标志物，作为治疗调节的目标，并作为药物反应的标志。我们还将讨论这些基于微生物组的方法目前的局限性。最终，更好地了解 NAFLD 中微生物群与宿主的相互作用将为开发新的预防策略和精确的治疗靶点提供信息。