Gut Microbiome and Hepatic Steatosis (Steatotic Liver Disease)

The gut–liver axis represents complex pathways of communication between the gut, the gut microbiota, and the liver that influence hepatic and systemic health. Hepatic steatosis, characterized by an accumulation of lipids in liver tissue, is one of the leading causes of chronic liver disease worldwide, with the potential to progress to more serious and irreversible forms of hepatic disease. It is becoming apparent that interactions between the host and its gut microbiota contribute to hepatic steatosis, but determining whether these interactions initiate hepatic steatosis and/or drive disease progression is difficult. What is clear is that metabolites produced by the gut microbiota influence aspects of hepatic steatosis, and they may prove invaluable in non-invasive diagnostic tools to allow earlier detection of fatty liver disease, reducing the global burden of disease and improving patient outcomes. This chapter summarizes our current knowledge on the role of the gut–liver axis in hepatic steatosis and provides information on microbiota-targeted interventions that may be able to ameliorate or treat hepatic steatosis in the future.