Dr. Nicolas Lanthier (Belgium) reviews the interaction between the gut microbiota and PPARs in NAFLD. He discusses the microbiota and its link to NAFLD and IR, where he explains the key role of the gut microbes in the metabolism of their host and highlights how liver becomes the first organ to be exposed to gut changes. He also reviews the role of peroxisome proliferator-activated receptor (PPARs) in metabolism, inflammation and in vascular and fibrosis modulation. He explains the human bacterial microbiota changes and how it can relate to other metabolic changes such as adipose tissue expansion, muscle mass and myosteatosis. To clinicians, he presents patient studies on probiotic and prebiotics, and its impact at various disease stages such as NAFLD, NASH, overweight and obesity.