Hormonal

In patients with nonalcoholic steatohepatitis (NASH), circulating bile acid profiles are significantly altered, characterized by increased primary bile acids (specifically conjugated cholate and taurocholate) and decreased secondary bile acids, which correlates with increased severity of hepatic steatosis, inflammation, and fibrosis.

This research highlights that NASH involves specific disruptions in bile acid metabolism, particularly an increase in primary bile acids like cholate and a decrease in secondary ones. While this paper does not prescribe a specific diet, it suggests that the composition of bile acids is a key driver of liver damage. Future interventions may focus on modulating bile acid profiles (e.g., via FXR agonists or dietary fiber to influence microbiome-derived secondary bile acids) to reduce inflammation and fibrosis risk.