腸内細菌叢の乱れと非アルコール性脂肪肝疾患・インスリン抵抗性の関連に基づく新たなアプローチ：レビュー
The global rise in obesity and type 2 diabetes has driven a parallel increase in the prevalence of nonalcoholic fatty liver disease (NAFLD), now recognized as the most frequent chronic liver condition in Western populations and a major indication for liver transplantation. This review synthesizes evidence from both animal and human studies demonstrating tight interconnections among insulin resistance, gut dysbiosis, and hepatic steatosis. The pathological cascade leading to increased intestinal permeability, hepatic inflammation, and fibrosis remains incompletely understood. A literature search across multidisciplinary databases was conducted using terms including 'NAFLD', 'gut dysbiosis', 'insulin resistance', 'inflammation', 'probiotics', and 'Chinese herbs'. Findings indicate that diverse interventions—probiotics, prebiotics, synbiotics, postbiotics, fecal microbiota transplantation, Chinese herbal medicine, antibiotics, polyphenol-rich and fasting diets, carbon nanoparticles, MCJ protein modulation, and molecular hydrogen-rich water—may favorably modify the NAFLD phenotype. The review provides a comprehensive framework for understanding how dysbiosis and insulin resistance jointly drive NAFLD progression and highlights current investigational strategies.
Gut dysbiosis exacerbates insulin resistance and increases intestinal permeability, allowing translocation of microbial products that trigger hepatic inflammatory signaling and lipid accumulation, thereby promoting NAFLD progression. Molecular hydrogen-rich water is noted as one of several adjunctive approaches that may attenuate this phenotype.
Hydrogen-rich water is a low-risk delivery route, but the achievable systemic hydrogen dose is bounded. For clinical applications, inhalation is the most efficient route; inhalation, however, carries explosion risk, and concentration matters (empirical LFL of 10% applies to inhalation environments; high-concentration devices are documented in the Consumer Affairs Agency accident database and are not recommended).
See also:
https://h2-papers.org/en/papers/36930488