Metabolism regulation centred on insulin resistance is increasingly important in nonalcoholic fatty liver disease (NAFLD). This review focuses on the interactions between the host cellular and gut microbial metabolism during the development of NAFLD. The cellular metabolism of essential nutrients, such as glucose, lipids and amino acids, is reconstructed with inflammation, immune mechanisms and oxidative stress, and these alterations modify the intestinal, hepatic and systemic environments, and regulate the composition and activity of gut microbes. Microbial metabolites, such as short-chain fatty acids, secondary bile acids, protein fermentation products, choline and ethanol and bacterial toxicants, such as lipopolysaccharides, peptidoglycans and bacterial DNA, play vital roles in NAFLD. The microbe–metabolite relationship is crucial for the modulation of intestinal microbial composition and metabolic activity. The intestinal microbiota and their metabolites participate in epithelial cell metabolism via a series of cell receptors and signalling pathways and remodel the metabolism of various cells in the liver via the gut–liver axis. Microbial metabolic manipulation is a promising strategy for NAFLD prevention, but larger-sampled clinical trials are required for future application.

中文翻译：

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宿主细胞和肠道微生物代谢在 NAFLD 发展和预防中的相互作用

以胰岛素抵抗为中心的代谢调节在非酒精性脂肪性肝病 (NAFLD) 中越来越重要。本综述重点关注 NAFLD 发展过程中宿主细胞和肠道微生物代谢之间的相互作用。葡萄糖、脂质和氨基酸等必需营养素的细胞代谢通过炎症、免疫机制和氧化应激重建，这些改变改变了肠道、肝脏和全身环境，并调节了肠道微生物的组成和活性。微生物代谢物，如短链脂肪酸、二级胆汁酸、蛋白质发酵产物、胆碱和乙醇以及细菌毒物，如脂多糖、肽聚糖和细菌 DNA，在 NAFLD 中起着至关重要的作用。微生物-代谢物的关系对于调节肠道微生物组成和代谢活动至关重要。肠道菌群及其代谢产物通过一系列细胞受体和信号通路参与上皮细胞代谢，并通过肠-肝轴重塑肝脏中各种细胞的代谢。微生物代谢操作是预防 NAFLD 的一种很有前景的策略，但未来的应用需要更大样本的临床试验。