Non-alcoholic fatty liver disease development: A multifactorial pathogenic phenomena

Non-alcoholic fatty liver disease (NAFLD), characterized by the accumulation of excessive intrahepatic fat, is a leading metabolic disorder also considered as the hepatic manifestation of metabolic syndrome (MS). Though more commonly observed in obese individuals and those with metabolic risk factors, it also develops in a considerable number of non-obese individuals as well as participants without having any component of MS. The basic mechanism involved in the development of fatty liver is the imbalance between lipid uptake, synthesis, and metabolism in the liver, normally controlled by several mechanisms to maintain lipid homeostasis. As a complex progressive liver disorder, the NAFLD pathogenesis is multifactorial, and several new pathogenic phenomena were discovered over time. The available liter-ature suggests the role of both genetic and environmental factors and associated metabolic factors; however, the mechanism of progression is not completely understood. In this review, we discuss different pathogenic mechanisms and their interplay to provide an elaborate idea regarding NAFLD development and progression. Better understanding of pathogenic mechanisms will be useful in finding new treatment for patients with NAFLD.& COPY; 2022 The Third Affiliated Hospital of Sun Yat-sen University. Publishing services by Elsevier B. V. on behalf of KeAi Communications Co., Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Automated summary

Non-alcoholic fatty liver disease (NAFLD) is a metabolic disorder characterized by the accumulation of excessive fat in the liver. It can occur in both obese and non-obese individuals, and its development is a complex, multifactorial process. The imbalance between lipid uptake, synthesis, and metabolism in the liver is the underlying mechanism, but the exact progression mechanism is not fully understood.