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Gut Permeability Linked to Fatty Liver Disease

NAFLD patients have greater permeability, more bacterial overgrowth than healthy subjects

FRIDAY, June 12 (HealthDay News) -- Patients with non-alcoholic fatty liver disease (NAFLD) may have greater intestinal permeability and a higher likelihood of small intestinal bacterial overgrowth, which correlate with steatosis severity, according to research published in the June issue of Hepatology.

Luca Miele, M.D., of the Catholic University of Rome, and colleagues analyzed data from 35 patients with NAFLD, 27 with newly diagnosed and untreated celiac disease, and 24 healthy subjects.

The researchers found that those with NAFLD had greater gut permeability, assessed by the 51Cr-ethylene diamine tetraacetate test, and more than twice the prevalence of small intestinal bacterial overgrowth than healthy volunteers. However, these were higher in celiac patients. Both factors were correlated in NAFLD patients with severity of steatosis. Also, the authors note, duodenal zonula occludens-1 staining in crypts and villi in NAFLD patients suggest that their increased permeability may be due to disruption of tight junction integrity.

"The gut harbors 15,000 to 35,000 species of bacteria, whose concentration and type are mainly influenced by host genotype and nutrient availability. It has been proposed that gut microbiota is able to promote steatohepatitis by enhancing hepatic exposure to endotoxins. Possible mechanisms include bacterial overgrowth, release of the lipopolysaccharide constituent of the gram-negative bacteria, and impaired intestinal barrier integrity, resulting in increased endotoxin absorption," write the authors of an accompanying editorial.

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