Bile acids associate with specific gut microbiota, low level alcohol consumption and liver fibrosis in patients with non-alcoholic fatty liver disease
Methods: Adult patients (n=122) underwent liver biopsy and BAs characterization by high-performance liquid chromatography/mass spectrometry. Gut microbiome composition was analysed using next-generation 16S rRNA sequencing. Diet and alcohol intake were determined by 3-day food diary.
Results: Serum and faecal BA concentrations increased progressively between non-NAFLD controls (n=55), NAFLD patients with no/mild fibrosis (F0-2, n=58), and NAFLD with advanced fibrosis (F3/4, n=9). Progressive increases in serum BAs were driven by primary conjugated BA's including glycocholic acid [GCA] and secondary conjugated BA's. In contrast, faecal BA increase was driven by secondary unconjugated BA's (predominately deoxycholic acid [DCA]). Serum GCA levels and faecal DCA levels correlated with the abundance of Bacteroidaceae and Lachnospiraceae, and stool secondary BAs with an unclassifiable family of the order Bacteroidales (Bacteroidales;other). These bacterial taxa were also associated with advanced fibrosis. Modest alcohol consumption was positively correlated with faecal DCA levels and relative abundance of Lachnospiracaea and Bacteroidales;other.
Conclusions: Higher serum and faecal BA levels are associated with advanced fibrosis in NAFLD. Specific gut bacteria link alterations in BA profiles and advanced fibrosis, and may be influenced by low level alcohol consumption.
History
Publication title
Liver InternationalVolume
40Issue
6Pagination
1356-1365ISSN
1478-3223Department/School
Menzies Institute for Medical ResearchPublisher
Wiley-Blackwell Publishing Ltd.Place of publication
United KingdomRights statement
Copyright 2020 John Wiley & Sons A/S. This is the peer reviewed version of the following article, which has been published in final form at http://dx.doi.org/10.1111/liv.14453. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived VersionsRepository Status
- Restricted