Nonalcoholic fatty liver disease: pathogenesis and intervention

Nonalcoholic fatty liver disease (NAFLD) is the most frequent liver disease in Western nations. NAFLD is characterized by intrahepatic fat accumulation (first “hit”) and can progress to nonalcoholic steatohepatitis by the second “hit,” such as free fatty acid lipotoxicity, and oxidative stress. It is believed that multifactorial complex interactions between diet, lifestyle, gut microbiota, and genetic background determine the development of NAFLD. Currently, the management of NAFLD is based on lifestyle modification, such as diet and physical activity, and pharmacological intervention. As the understanding of NAFLD pathophysiology furthers, some interesting novel approaches to treating NAFLD are emerging, such as antioxidants and probiotics. This review is focused on the pathogenesis of NAFLD and potential therapeutic approaches to treat the disease.