Obesity-triggered co-morbidities, such as insulin resistance and the accompanying nonalcoholic fatty liver disease represent major health care burdens worldwide. The first step in the pathogenesis of the disease is the triglyceride deposition in the liver. The resulting hepatic steatosis may lead to steatohepatitis, cryptogenic cirrhosis and eventually, hepatocellular cancer. Steatosis develops when fatty acid uptake and lipogenesis overwhelm fatty acid oxidation and secretion. We highlight these molecular mechanisms in this review to provide further information to understand the background of nonalcoholic fatty liver disease and the cardiometabolic complications that escort obesity and insulin resistance.
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