Glycine-metabolizing and taurine-metabolizing bacteria were increased in NAFLD patients, which may help explain the increase in secondary BAs in the BA pool.85 Furthermore, when intestinal microflora composition is altered, conjugated BAs and their metabolites can be increased, which inhibits intestinal FXR signaling leading to reduced BA secretion from the liver and promotion of NAFLD.86 This evidence concerns the gene NR1H4 and metabolic dysfunction-associated steatotic liver disease.