Gut microbiota in adolescents and the association with fatty liver: the EPOCH study

Pediatr Res. 2018 Aug;84(2):219-227. doi: 10.1038/pr.2018.32. Epub 2018 Apr 18.


Background: Recent evidence supports that the gut microbiota may be involved in the pathophysiology of non-alcoholic fatty liver disease (NAFLD), and may also offer avenues for treatment or prevention.

Methods: We investigated the associations among gut microbiota, diet, and hepatic fat fraction (HFF) in 107 adolescents. Magnetic resonance imaging (MRI) was used to assess HFF, and 16S rRNA gene sequencing was performed on collected fecal samples. Dietary intake was assessed using Food Frequency Questionnaires. We examined the association between gut microbiota alpha diversity and HFF, and assessed the predictive accuracy for HFF of (1) taxonomic composition, (2) dietary intake, (3) demographic and comorbid conditions, and (4) the combination of these.

Results: Lower alpha diversity was associated with higher HFF (β=-0.19, 95% confidence interval (CI) -0.36, -0.02). The selected taxa explained 17.7% (95% CI: 16.0-19.4%) of the variation in HFF. The combination of two of these taxa, Bilophila and Paraprevotella, with dietary intake of monounsaturated fatty acids and BMI z-scores explained 32.0% (95% CI: 30.3-33.6%) of the variation in HFF.

Conclusion: The gut microbiota is associated with HFF in adolescents and may be useful to help identify youth who would be amenable to gut microbiota-based interventions.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Body Mass Index
  • Child
  • Comorbidity
  • Diet
  • Feces
  • Female
  • Gastrointestinal Microbiome*
  • Humans
  • Insulin Resistance
  • Liver / diagnostic imaging*
  • Magnetic Resonance Imaging
  • Male
  • Non-alcoholic Fatty Liver Disease / diagnosis*
  • Non-alcoholic Fatty Liver Disease / microbiology*
  • Obesity
  • Prospective Studies
  • RNA, Ribosomal, 16S / genetics
  • Surveys and Questionnaires
  • Young Adult


  • RNA, Ribosomal, 16S