Nonalcoholic Fatty Liver Disease: Pathogenesis and the Role of Antioxidants

Authors

  • Kapil Mehta,

    1. Drs. Mehta, VanThiel, Shah, and Mobarhan arewith the Division of Gastroenterology, Hepatology, and Nutrition, Loyola University Medical Center, 2160 South First Avenue, Maywood, Illinois 60153, USA.
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  • David H. Van Thiel,

    1. Drs. Mehta, VanThiel, Shah, and Mobarhan arewith the Division of Gastroenterology, Hepatology, and Nutrition, Loyola University Medical Center, 2160 South First Avenue, Maywood, Illinois 60153, USA.
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  • Nikunj Shah,

    1. Drs. Mehta, VanThiel, Shah, and Mobarhan arewith the Division of Gastroenterology, Hepatology, and Nutrition, Loyola University Medical Center, 2160 South First Avenue, Maywood, Illinois 60153, USA.
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  • Sohrab Mobarhan

    1. Drs. Mehta, VanThiel, Shah, and Mobarhan arewith the Division of Gastroenterology, Hepatology, and Nutrition, Loyola University Medical Center, 2160 South First Avenue, Maywood, Illinois 60153, USA.
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Abstract

Nonalcoholic fatty liver disease (NAFLD) includes a wide spectrum of liver injury ranging from simple steatosis to steatohepatitis, fibrosis, and cirrhosis. Whereas simple steatosis has a benign clinical course, steatohepatitis is a recognized cause of progressive liver fibrosis and can develop into cirrhosis. NAFLD and nonalcoholic steatohepatitis (NASH) are the two most common chronic liver diseases in United States general population with a prevalence of 20% and 3%, respectively. Hepatic steatosis is frequently associated with obesity, type 2 diabetes, and hyperlipidemia with insulin resistance as a key pathogenic factor. A two-hit theory best describes the progression from simple steatosis to NASH, fibrosis, or cirrhosis. These two hits consist of the accumulation of excessive hepatic fat primarily owing to insulin resistance, and oxidative stress owing to reactive oxygen species (ROS). Mitochondria are the major cellular source of ROS in cases of NASH. Currently, treatment is focused on modifying risk factors such as obesity, diabetes mellitus, and hyperlipidemia. Antioxidants such as vitamin E, N-acetylcysteine, betaine, and others may be beneficial in the treatment of NASH.

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