Gut Microbiota Profiles in Nonalcoholic Fatty Liver Disease and Its Possible Impact on Disease Progression Evaluated with Transient Elastography: Lesson Learnt from 60 Cases

BACKGROUND: Dysbiosis of the gut microbiota has been considered to have a role in nonalcoholic fatty liver disease (NAFLD) progression. However, there is still lack of studies regarding this phenomenon. AIM: To find the difference in the proportion of gut microbiota in NAFLD patients based on the stages of liver fibrosis. PATIENTS AND METHODS: A cross-sectional study was conducted at Dr. Cipto Mangunkusumo Hospital, which is the largest tertiary referral center. Human fecal samples from NAFLD patients who came to the outpatient clinic were collected consecutively. The stool sample examination was performed using an isolation DNA kit (Tiangen) and quantitative real-time polymerase chain reaction (Fast 7500). Clinical and laboratory data were also collected. The stage of fibrosis was diagnosed based on transient elastography (FibroScan® 502 Touch; Echosens, France). RESULTS: Of 60 NAFLD human fecal samples, 35 patients had nonsignificant fibrosis and 25 patients had significant fibrosis (46.7% male and 53.3% female; median age 56 years). Most patients had diabetes (85%), dyslipidemia (58.3%), obesity (58.3%), and central obesity (90%). The proportion of Bacteroides was higher when compared to Lactobacillus and Bifidobacteria. Of these 3 microbiota, the proportion of Bacteroides was significantly higher in the significant fibrosis group when compared to the nonsignificant fibrosis group. CONCLUSION: There is a change in the composition of gut microbiota in NAFLD patients. The proportion of Bacteroides is significantly higher in significant liver fibrosis, which may play a role in NAFLD progression.