Figure 1.

Several signaling pathways affected by metabolites in the MVA pathway involved in the progression from NAFLD to HCC. The progression of NAFLD to HCC is classified into four phases: normal liver, NAFL (simple steatosis), NASH, and HCC. When NAFLD develops, insulin resistance occurs as PI3K-Akt is activated in the liver. Simultaneously, LXR-α and AMPK, sensors of metabolic state dysfunction, promote DNL and glucose uptake. Activation of Rac1 and Ras-FasL is involved in the development of NASH by promoting cirrhosis and apoptosis. Then the Ras-ERK1/2 axis mediates proliferation, leading to the onset of HCC. All of the above pathways are regulated by metabolites in the MVA pathway, and corresponding targeted therapies have been developed.