Definition, Pathogenesis, and Natural Progress of Non-alcoholic Fatty Liver Disease

Jae-Han Jeon; Keun-Gyu Park

doi:10.4093/jkd.2014.15.2.65

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Jeon and Park: Definition, Pathogenesis, and Natural Progress of Non-alcoholic Fatty Liver Disease

Focused Issue

J Korean Diabetes 2014;15(2):65-70.

Published online: 20 January 2014

DOI: https://doi.org/10.4093/jkd.2014.15.2.65

Definition, Pathogenesis, and Natural Progress of Non-alcoholic Fatty Liver Disease

Jae-Han Jeon, Keun-Gyu Park

Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Non-alcoholic fatty liver disease (NAFLD) is emerging as a world-wide health problem and is currently recognized as a hepatic manifestation of metabolic syndrome. It is an umbrella term to describe a wide range of diseases from simple steatosis to non-alcoholic hepatosteatosis (NASH) and NSAH-related liver cirrhosis. NAFLD is mainly associated with insulin resistance which allows increased free fatty acid (FFA) flux to the liver by increasing lipolysis from adipose tissue, triggering macrophage/immune activation, decreasing skeletal muscle glucose uptake, and increasing de novo lipogenesis. Increased FFA pool in the liver, in turn, increases lipotoxic intermediates, such as ceramides, diacylglycerols, and lysophosphatidylcholines, which are responsible for mitochondrial dysfunction and endoplasmic reticulum stress, resulting in inflammation of the liver. When inflammation is severe enough to affect stellate cells, hepatic fibrosis can be induced.

Keywords: Free fatty acid, Insulin resistance, Non-alcoholic fatty liver disease, Obesity

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