Interestingly, Lactobacillus, Ruminococcus, and Bacteroides mainly take part in the deconjugation of primary BAs, and it has been reported that an intestinal flora imbalance can activate FXR by affecting intestinal BA metabolism [42], increasing the expression of FGF15, reducing hepatic BA synthesis, and causing cholesterol metabolism disorders [43]. This evidence concerns the gene NR1H4 and Other metabolic disease.