IMR Press / FBL / Volume 10 / Issue 2 / DOI: 10.2741/1636

Frontiers in Bioscience-Landmark (FBL) is published by IMR Press from Volume 26 Issue 5 (2021). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with Frontiers in Bioscience.

Open Access Article
Insulin resistance in NASH
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1 Division of Gastroenterology, Hepatology and Nutrition, Dept. of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA

Academic Editor: Nobuhiro Sato

Front. Biosci. (Landmark Ed) 2005, 10(2), 1520–1533; https://doi.org/10.2741/1636
Published: 1 May 2005
(This article belongs to the Special Issue Non alcoholic fatty liver disease NAFLD)
Abstract

Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease observed in the clinical practice of hepatology. The coexistence of metabolic syndrome in this cohort of patients has made insulin resistance central to the pathogenesis of these disorders. The metabolic consequence of insulin resistance is impaired hepatic glucose output and abnormal lipid handling. In the face of continued metabolic insults the normal hepatic regulatory mechanism gets overwhelmed and fat accumulates in the hepatocytes. The subsequent fate of steatotic hepatocytes depends on the capacity of additional factors such as adipocytokines and toxicity induced by the free fatty acids themselves to induce inflammatory response. This latter process is responsible for the producing the phenotype of non-alcoholic steatohepatitis (NASH). Irrespective of the process by which these phenotypic response occurs, it is now universally accepted that in the absence of insulin resistance the spectrum of changes one associates with NAFLD does not develop. In this review we will discuss the various processes that are involved in the pathogenesis of NAFLD.

Keywords
Fatty liver
Nonalcoholic steatohepatitis
Nonalcoholic fatty liver disease
Nonalcoholic fatty liver
Insulin resistance
Free fatty acids
Oxidative stress
Metabolic syndrome
Obesity
Review
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