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. 2020 Nov 11;9(11):2458. doi: 10.3390/cells9112458

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© 2020 by the authors.

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).

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Factors contributing to development of NASH or progression of NAFL to NASH. NAFLD develops due to excess calorie intake, which leads to adipose tissue hypertrophy. Adipose tissue confronted with nutrient overload will increase lipolysis and change secretion of adipokines. This altered systemic situation of nutrients, lipids and adipokines, ultimately resulting in NAFLD, is modulated by genetic, epigenetic, environmental and metabolic factors (outer ring). Various molecular and cellular mechanisms (cogs) interact in development of NAFLD and NASH. Abbrevations: ATP: adenosine triphosphate; β-oxidation: beta oxidation of lipid components within mitochondria; DNL: de novo lipogenesis; ER stress: endoplasmatic reticulum stress; FFA: free fatty acids; UPR: unfolded protein response.